| NPI | 1306077839 |
|---|---|
| NPI Type | NPI-2 Organization |
| Status | Active |
| Enumeration Date | 2009-07-31 |
| Last Updated | 2013-01-21 |
| Authorized Official | Jeffrey Irvin Owner Phone: 8124017777 |
| Mailing Address | 634 Cross Valley Cir Evansville, IN 47710-5238 United States Phone: (812) 401-7777 📍 View Map |
| Primary Practice Address | 634 Cross Valley Cir Evansville, IN 47710-5238 United States Phone: (812) 401-7777 | Fax: (812) 429-0392 📍 View Map |
| Issuer | State | Number | Other Issuer |
|---|---|---|---|
| MEDICAID | IN | 200981140 | - |
| Other (non-Medicare) | IN | 6503910001 | DMERC |
| Other (non-Medicare) | IN | DR3932 | RAILROAD MEDICARE |
| Primary | Taxonomy Code & Description | State | License Number |
|---|---|---|---|
| No | 152W00000X – Optometrist | IN | 18003181 |
| Yes | 152W00000X – Optometrist | IN | 18003164 |
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About NPI 1306077839
Northside Eyecare Associates, Llc is an organization registered in the CMS NPPES NPI Registry with NPI number 1306077839. The primary specialty listed is Optometrist. The organization is located in Evansville, IN. This NPI is classified as a Type 2 (Organizational) NPI and is currently active. The NPI was first enumerated (assigned) on 2009-07-31. All data is sourced directly from the official CMS NPPES public API and is updated daily.
Frequently Asked Questions
What is NPI 1306077839?
NPI 1306077839 belongs to Northside Eyecare Associates, Llc, a Optometrist in Evansville, IN. It is a Type 2 Organizational NPI registered in the CMS NPPES NPI Registry.
Is NPI 1306077839 active?
The current status of NPI 1306077839 in the NPPES registry is Active. The record was last updated on 2013-01-21.
What specialty is NPI 1306077839?
NPI 1306077839 is classified under the taxonomy Optometrist. Taxonomy codes in NPPES are maintained by the National Uniform Claim Committee (NUCC) and identify the provider's type, classification, and specialization.
How do I verify NPI 1306077839?
You can verify NPI 1306077839 at the official CMS NPPES website at npiregistry.cms.hhs.gov or using our free NPI Lookup tool above. All data shown on this page is sourced directly from the official NPPES public API and is updated daily by CMS.
What address is on file for NPI 1306077839?
The primary practice address on file for NPI 1306077839 is 634 Cross Valley Cir, Evansville, IN 47710-5238. This address is registered in the NPPES system and providers are required to update it within 30 days of any change.
When was NPI 1306077839 issued?
NPI 1306077839 was first issued (enumerated) on 2009-07-31. The NPPES record was last updated on 2013-01-21.
Practice Location Map
Northside Eyecare Associates, Llc is located at 634 Cross Valley Cir, Evansville, IN. Use the map below to find directions or verify the practice location.
Related Healthcare Providers
The following providers share the same practice location, specialty, or state as Northside Eyecare Associates, Llc. All records sourced from the CMS NPPES registry.
License Information
The following state license numbers are on file in the NPPES registry for NPI 1306077839. For license status verification, contact the relevant state licensing board directly.
| Specialty / Taxonomy | License Number | State |
|---|---|---|
| Optometrist | 18003181 | IN |
| Optometrist | 18003164 | IN |