Active NPI
Kregg Koons O.D., Inc.
- Optometrist
- Muncie, IN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 18002701
- Legal business name
- KREGG KOONS O.D., INC.
- Practice address
- 3300 W Fox Ridge LN
Muncie, IN 47304-5201 - Phone
- (765) 289-4727
- Fax
- (765) 751-2207
- NPI assigned
- Jan 3, 2013
- Last updated
- Aug 27, 2015
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Kregg C Koons, O.D.
- Title
- Owner
- Phone
- (765) 289-4727
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 18002701 | IN | Primary |
Addresses
Primary practice location
3300 W Fox Ridge LN
Muncie, IN 47304-5201
Mailing address
3300 W Fox Ridge LN
Muncie, IN 47304-5201
Phone (765) 289-4727
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100376600 | Medicaid | IN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IN
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20050115000021 | IN | Part B Supplier - Clinic/Group Practice | 5698724706 |
Receives reassigned benefits from 3 practitioners 2 other NPIs on this enrollment Practice locations: Muncie, IN |
| O20150908002494 | IN | DME Supplier - Physician - Optometrist | 5698724706 | Practice locations: Muncie, IN |
Other NPIs with the same Medicare PAC ID 1
NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).
Other NPIs on the same Medicare enrollment 2
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
National Provider Directory
National Provider Directory- Tax ID family
- Alan Lenig OD Inc
Other organizations with this tax ID 2
Organizations that report the same tax identification number in the National Provider Directory.
-
- Optometrist
- Anderson, IN
- NPI 1215274626
-
- Optometrist
- Muncie, IN
- NPI 1235624289
Practitioners & affiliated clinicians
Practitioners 3
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.
-
- Optometrist
- Muncie, IN
- NPI 1962515791
-
- Optometrist
- Anderson, IN
- NPI 1467713594
-
- Optometrist
- Muncie, IN
- NPI 1609438423
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1357171200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1440633600000",
"number": "1902143456",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3300 W FOX RIDGE LN",
"city": "MUNCIE",
"state": "IN",
"postal_code": "473045201",
"telephone_number": "765-289-4727",
"fax_number": "765-751-2207"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3300 W FOX RIDGE LN",
"city": "MUNCIE",
"state": "IN",
"postal_code": "473045201",
"telephone_number": "765-289-4727",
"fax_number": "765-751-2207"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "KREGG KOONS O.D., INC.",
"organizational_subpart": "NO",
"enumeration_date": "2013-01-03",
"last_updated": "2015-08-27",
"status": "A",
"authorized_official_last_name": "KOONS",
"authorized_official_first_name": "KREGG",
"authorized_official_middle_name": "C",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "765-289-4727",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "O.D."
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "IN",
"license": "18002701",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100376600",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Muncie, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2015; 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.