Dr. Timothy H. McGillen Professional Optometric Corporation

Primary specialty

OptometristTaxonomy code 152W00000X

License

56000072A Issued in IN

Legal business name

DR. TIMOTHY H. MCGILLEN PROFESSIONAL OPTOMETRIC CORPORATION

Practice address

279 W 80TH PL
Merrillville, IN 46410-5491

Phone

(219) 738-2180

Fax

(219) 738-2847

NPI assigned

Feb 23, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Timothy H. McGillen, O.D.

Title

President

Phone

(219) 738-2180

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1172188800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1357516800000",
    "number": "1942335286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "279 W 80TH PL",
            "city": "MERRILLVILLE",
            "state": "IN",
            "postal_code": "464105491",
            "telephone_number": "219-738-2180",
            "fax_number": "219-738-2847"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "279 W 80TH PL",
            "city": "MERRILLVILLE",
            "state": "IN",
            "postal_code": "464105491",
            "telephone_number": "219-738-2180",
            "fax_number": "219-738-2847"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. TIMOTHY H. MCGILLEN PROFESSIONAL OPTOMETRIC CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-23",
        "last_updated": "2013-01-07",
        "status": "A",
        "authorized_official_last_name": "MCGILLEN",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_middle_name": "H.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "219-738-2180",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "IN",
            "license": "56000072A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201037950A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2013; 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.