Charles Michael Rissler, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

18001745A Issued in IN

Practice address

2373 E Main St
Plainfield, IN 46168-2717

Phone

(317) 839-0713

Fax

(317) 837-4093

NPI assigned

Apr 25, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1145923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320796800000",
    "number": "1902862386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1125 BALTUSTROL RUN",
            "city": "AVON",
            "state": "IN",
            "postal_code": "461237067",
            "telephone_number": "317-696-7851"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2373 E MAIN ST",
            "city": "PLAINFIELD",
            "state": "IN",
            "postal_code": "461682717",
            "telephone_number": "317-839-0713",
            "fax_number": "317-837-4093"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RISSLER",
        "first_name": "CHARLES",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-25",
        "last_updated": "2011-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IN",
            "license": "18001745A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100193380",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "000000385426",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Optometrist in Plainfield, IN
• Providers in Plainfield, IN by specialty
• Optometrist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2011; 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.