NPIMap

Organization Active NPI

Eyecare Indiana II, PC

  • Optometrist
  • Valparaiso, IN
National Provider Identifier
1861743783
Registry record updated Nov 16, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
EYECARE INDIANA II, PC
Practice address
3540 Calumet Ave
Valparaiso, IN 46383-2246
Phone
(219) 462-5113
Fax
(219) 462-8398
NPI assigned
Oct 2, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 16, 2012

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

Authorized official

Name
Terri Peschke
Title
Coo
Phone
(574) 291-9200

Specialties & licenses 1

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

Addresses

Primary practice location

3540 Calumet Ave
Valparaiso, IN 46383-2246

Mailing address

4121 S Michigan St
South Bend, IN 46614-2545
Phone (574) 291-9200

Other names 1

  • C&B OPTICAL ONE Doing business as

National Provider Directory

National Provider Directory
Tax ID family
CB Optical One11 organizations share this tax ID, including this one

Other organizations with this tax ID 10

Organizations that report the same tax identification number in the National Provider Directory.

Locations

3540 Calumet Ave
Valparaiso, IN 46383
Phone (219) 462-1484

NPI Registry JSON

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

{
    "created_epoch": "1349136000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1353024000000",
    "number": "1861743783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4121 S MICHIGAN ST",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466142545",
            "telephone_number": "574-291-9200",
            "fax_number": "574-299-4423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3540 CALUMET AVE",
            "city": "VALPARAISO",
            "state": "IN",
            "postal_code": "463832246",
            "telephone_number": "219-462-5113",
            "fax_number": "219-462-8398"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYECARE INDIANA II, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-02",
        "last_updated": "2012-11-16",
        "status": "A",
        "authorized_official_last_name": "PESCHKE",
        "authorized_official_first_name": "TERRI",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "574-291-9200"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "C&B OPTICAL ONE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Valparaiso, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 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.