Organization Active NPI

Dr. Timothy H. McGillen Professional Optometric Corporation

  • Optometrist
  • Merrillville, IN
National Provider Identifier
1942335286
Registry record updated Jan 7, 2013
On this page

Key facts

NPPES NPI Registry
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
Last updated
Jan 7, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2013

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.NPI 1285769133
Title
President
Phone
(219) 738-2180

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 56000072A IN Primary

Addresses

Primary practice location

279 W 80TH PL
Merrillville, IN 46410-5491

Mailing address

279 W 80TH PL
Merrillville, IN 46410-5491
Phone (219) 738-2180

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Merrillville, IN

Sources for this page

  • 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.