NPIMap

Organization Active NPI

Aecc LLC

  • Optometrist
  • Fishers, IN
National Provider Identifier
1821867649
Registry record updated Jun 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
AECC LLC
Practice address
10967 Allisonville Rd Ste 120
Fishers, IN 46038-2634
Phone
(317) 902-4239
NPI assigned
Dec 20, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Daniel Bollier, ODNPI 1942703210
Title
Optometrist
Phone
(317) 902-4239

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X Primary

Addresses

Primary practice location

10967 Allisonville Rd Ste 120
Fishers, IN 46038-2634

Mailing address

10967 Allisonville Rd Ste 120
Fishers, IN 46038-2634
Phone (317) 577-0707

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240118003060 IN Part B Supplier - Clinic/Group Practice 4880046424 Receives reassigned benefits from 3 practitioners
Practice locations: Fishers, IN

National Provider Directory

National Provider Directory

Locations

10967 Allisonville Rd
Ste 120
Fishers, IN 46038
Phone (317) 577-0707

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1703030400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1717459200000",
    "number": "1821867649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10967 ALLISONVILLE RD STE 120",
            "city": "FISHERS",
            "state": "IN",
            "postal_code": "460382634",
            "telephone_number": "317-577-0707",
            "fax_number": "317-577-1567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10967 ALLISONVILLE RD STE 120",
            "city": "FISHERS",
            "state": "IN",
            "postal_code": "460382634",
            "telephone_number": "317-902-4239"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AECC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-12-20",
        "last_updated": "2024-06-04",
        "certification_date": "2024-06-04",
        "status": "A",
        "authorized_official_last_name": "BOLLIER",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "317-902-4239",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fishers, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.