Abbott Eye Clinic Inc PC

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

Legal business name

ABBOTT EYE CLINIC INC PC

Doing business as

Image Optical

Practice address

2222 W Lexington Ave
Elkhart, IN 46514-1420

Phone

(574) 294-3030

Fax

(574) 294-3544

NPI assigned

Nov 8, 2006

Last updated

Oct 19, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Kenneth W Abbott, MDNPI 1770664138

Title

President Owner

Phone

(574) 294-3030

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Image Optical Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Kenneth W Abbott, MD

  • Ophthalmology Physician
  • Elkhart, IN
  • NPI 1770664138
  NPD (past) Authorized official

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

{
    "created_epoch": "1162944000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1350604800000",
    "number": "1831268150",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2222 W LEXINGTON AVE",
            "city": "ELKHART",
            "state": "IN",
            "postal_code": "465141420",
            "telephone_number": "574-294-3030",
            "fax_number": "574-294-3544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2222 W LEXINGTON AVE",
            "city": "ELKHART",
            "state": "IN",
            "postal_code": "465141420",
            "telephone_number": "574-294-3030",
            "fax_number": "574-294-3544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ABBOTT EYE CLINIC INC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-08",
        "last_updated": "2012-10-19",
        "status": "A",
        "authorized_official_last_name": "ABBOTT",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "PRESIDENT OWNER",
        "authorized_official_telephone_number": "574-294-3030",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DMER",
            "identifier": "4018880001",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Image Optical",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• 111 Home Health Care Agency
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• 42 North Dental Care of Indiana, LLC (Greenleaf Family Dentistry)
• Kenneth W Abbott, MD
• Gerald Abell II, RBT
• Jad Abou Rjeily, RPH
• Matthew Lee Abrell, DPM
• Davida Acheampong, MSW

• Ophthalmology Physician in Elkhart, IN
• Providers in Elkhart, IN by specialty
• Ophthalmology Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.