DR. MICHAEL JOHN ROTHEKER (NPI# 1316935208) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316935208 |
| Entity Type | Individual |
| Full Name | DR. MICHAEL JOHN ROTHEKER |
| Credential | O.D. |
| Practice Address |
17615 State Road 23 South Bend IN 46635 |
| Mailing Address |
4121 S. Michigan Street South Bend IN 46614-2545 |
| Practice Telephone | 5742347600 |
| Practice Fax Number | 5742348408 |
| Mailing Telephone | 5742919200 |
| Mailing Fax Number | 5742994423 |
| Enumeration Date | 2005-10-13 |
| Last Update Date | 2018-08-14 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 152W00000X | Optometrist | 18003124A | IN | Eye and Vision Services Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | ANTHEM MC/BS | 000000215766 | 01 |
| IN | 200335390A | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902956451 | Michael Rotheker Sr. | Technician/Technologist | 7211 Taft St, Merrillville, IN 46410-3731 | 2007-01-10 |
| Street Address |
17615 STATE ROAD 23 |
| City | SOUTH BEND |
| State | IN |
| Zip Code | 46635 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467802397 | Morgan Dewit | Optometrist | 17615 State Road 23, South Bend, IN 46635 | 2016-06-22 |
| 1558592170 | Midwest Eye Consultants P.C. | Optometrist | 17615 State Road 23, South Bend, IN 46635-1718 | 2009-07-30 |
| 1912098229 | Professional Vision Inc | Optometrist | 17615 State Road 23, South Bend, IN 46635-1718 | 2006-09-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295078228 | Michael Pfeiffer | Otolaryngology | 6301 University Commons Ste 360, South Bend, IN 46635 | 2013-03-27 |
| 1679833438 | Whitney Moore | Physical Therapy Assistant | 2012 Ironwood Circle, Suite 230, Circle Centre Building, South Bend, IN 46635 | 2012-05-25 |
| 1992917637 | Elly May Wynia | Social Worker | 53700 Generations Drive, Suite 200, South Bend, IN 46635 | 2007-05-04 |
| 1891917282 | Lifetime Dental Careof Indiana, PC | Dentist | 1605 North Ironwood, South Bend, IN 46635 | 2007-05-03 |
| 1750502878 | Tyrone Arteese Armstead | Pharmacist | 3355 Douglas Rd, South Bend, IN 46635 | 2007-05-02 |
| 1013033794 | Bradley Richard Swanson | Dentist | 54505 26th Street, Unit E, South Bend, IN 46635 | 2007-03-22 |
| 1225185739 | Michael J. O'connell D.o. Inc | Family Medicine | 17960 Cleveland Road, South Bend, IN 46635 | 2007-01-05 |
| 1346300365 | Chad Fulton Harrington | Dentist | 3340 Douglas Rd., South Bend, IN 46635 | 2006-12-11 |
| 1346313236 | Dr Shawn R Long Dds PC | Dentist | 16329 State Rd 23, South Bend, IN 46635 | 2006-11-16 |
| 1134206576 | Kearn David Hinchman | Psychiatry & Neurology | 53779 Generations Drive, Suite 1, South Bend, IN 46635 | 2006-11-01 |
| Find all providers in zip 46635 | ||||
| Taxonomy Code | 152W00000X |
| Grouping | Eye and Vision Services Providers |
| Classification | Optometrist |
| Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system. |
| Notes: Source: American Optometric Association (AOA), approved by the AOA’s Board of Trustees, June 21, 2005. [7/1/2006: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104312552 | Myeyedr Optometry of Indiana, LLC | Optometrist | 315 W Ireland Rd # 103, South Bend, IN 46614-3802 | 2018-07-09 |
| 1831649706 | Ossip Optometry, PC | Optometrist | 315 W Ireland Rd, Unit 103, South Bend, IN 46614-3802 | 2016-10-04 |
| 1275848962 | Charles Mikel Craig | Optometrist | 220 N. Ironwood Dr., South Bend, IN 46615 | 2010-08-18 |
| 1902944325 | Family Eye Care of South Bend | Optometrist | 220 North Ironwood, South Bend, IN 46615-1623 | 2007-02-01 |
| 1700971686 | Professional Vision Inc | Optometrist | 4630 W Western Ave, South Bend, IN 46619-2304 | 2006-10-04 |
| 1972520906 | Ossip Optometry, P.c | Optometrist | 4121 S Michigan St, South Bend, IN 46614-2545 | 2006-07-16 |
| 1023069283 | Christopher J. Wolf, Od, Inc | Optometrist | 4123 S Michigan St, South Bend, IN 46614-2545 | 2006-05-13 |
| 1740241975 | Bob H Graf | Optometrist | 2004 Edison Rd Ste A, South Bend, IN 46617-1712 | 2006-03-29 |
| 1740258441 | Ronald Lee Snyder | Optometrist | 17615 State Rd 23, South Bend, IN 46635 | 2006-03-09 |
| 1306813464 | Lawrence A Shinneman | Optometrist | 4121 S. Michigan Street, South Bend, IN 46614-2545 | 2006-03-07 |
| Find all providers in SOUTH BEND | ||||
| City | SOUTH BEND |
| Zip Code | 46635 |
Please comment or provide details below to improve the information on DR. MICHAEL JOHN ROTHEKER.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.