Organization Active NPI

Dr Coker Family Eye Care Center Inc

  • Optometrist
  • Jeffersonville, IN
National Provider Identifier
1982896957
Registry record updated Jun 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
DR COKER FAMILY EYE CARE CENTER INC
Practice address
432 Wall St
Jeffersonville, IN 47130-3428
Phone
(122) 837-4928
Fax
(812) 283-7599
NPI assigned
Aug 14, 2007
Organization subpart
Yes
Parent organization
DR COKER FAMILY EYE CARE CENTER INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 3, 2022

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

Authorized official

Name
Mrs. Dawn M Coker
Title
Manager/Owner
Phone
(812) 283-7492

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 152W00000X 1408DT KY
OptometristGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 152W00000X Primary

Addresses

Primary practice location

432 Wall St
Jeffersonville, IN 47130-3428

Mailing address

432 Wall St
Jeffersonville, IN 47130-3428
Phone (122) 837-4928

Other identifiers 1

IdentifierTypeStateIssuer
IN2715MedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20071022000566 IN Part B Supplier - Clinic/Group Practice 0143316182 Receives reassigned benefits from 1 practitioner
Practice locations: Jeffersonville, IN

National Provider Directory

National Provider Directory
Part of
Dr Coker Family Eye Care Ce

Locations

432 Wall St
Jeffersonvlle, IN 47130
Phone (812) 283-7492

2827 Preston Hwy
Louisville, KY 40217
Phone (502) 636-0451

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1187049600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1654214400000",
    "number": "1982896957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "432 WALL ST",
            "city": "JEFFERSONVILLE",
            "state": "IN",
            "postal_code": "471303428",
            "telephone_number": "122-837-4928",
            "fax_number": "812-283-7599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "432 WALL ST",
            "city": "JEFFERSONVILLE",
            "state": "IN",
            "postal_code": "471303428",
            "telephone_number": "122-837-4928",
            "fax_number": "812-283-7599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR COKER FAMILY EYE CARE CENTER INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DR COKER FAMILY EYE CARE CENTER INC",
        "enumeration_date": "2007-08-14",
        "last_updated": "2022-06-03",
        "certification_date": "2022-06-03",
        "status": "A",
        "authorized_official_last_name": "COKER",
        "authorized_official_first_name": "DAWN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "MANAGER/OWNER",
        "authorized_official_telephone_number": "812-283-7492",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "KY",
            "license": "1408DT",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "IN2715",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jeffersonville, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2022; 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.

Verify at the official NPI Registry.