Active NPI
Ossip Optometry, P.C
Doing business as C&B Optical One
- Optometrist
- South Bend, IN
National Provider Identifier
1972520906
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 18003467
- Legal business name
- OSSIP OPTOMETRY, P.C
- Doing business as
- C&B Optical One
- Practice address
- 4121 S Michigan St
South Bend, IN 46614-2545 - Phone
- (574) 291-9200
- Fax
- (574) 299-4423
- NPI assigned
- Jul 16, 2006
- Last updated
- Oct 13, 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. Gregg L Ossip, OD
- Title
- Owner
- Phone
- (317) 254-6480
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 18003467 | IN | Primary |
Addresses
Primary practice location
4121 S Michigan St
South Bend, IN 46614-2545
Mailing address
9795 Crosspoint Blvd
Ste 100
Indianapolis, IN 46256-3354
Phone (317) 254-6480
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 201052070 | Medicaid | IN |
Other names 1
- C&B Optical One
National Provider Directory
National Provider Directory- Tax ID family
- Ossip Optometry
Other organizations with this tax ID 25
Organizations that report the same tax identification number in the National Provider Directory.
-
- Optometrist
- Camby, IN
- NPI 1639353725
-
- Optometrist
- Fishers, IN
- NPI 1093111783
Locations
14 Professional Ct
Lafayette, IN 47905
Phone (765) 447-5083
5327 Grape Rd
Mishawaka, IN 46545
Phone (574) 277-8121
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153008000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1444694400000",
"number": "1972520906",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9795 CROSSPOINT BLVD",
"address_2": "STE 100",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462563354",
"telephone_number": "317-254-6480",
"fax_number": "317-259-8609"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"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"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "OSSIP OPTOMETRY, P.C",
"organizational_subpart": "NO",
"enumeration_date": "2006-07-16",
"last_updated": "2015-10-13",
"status": "A",
"authorized_official_last_name": "OSSIP",
"authorized_official_first_name": "GREGG",
"authorized_official_middle_name": "L",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "317-254-6480",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "OD"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Optometrist",
"state": "IN",
"license": "18003467",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "201052070",
"state": "IN"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "C&B Optical One",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in South Bend, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.