GREATER LAFAYETTE RETINA CENTER, P.C. (NPI# 1629280813) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1629280813 |
Entity Type | Organization |
Organization Name | GREATER LAFAYETTE RETINA CENTER, P.C. |
Practice Address |
1013 N 13th St Lafayette IN 47904-2011 |
Practice Telephone | 7654288888 |
Practice Fax Number | 7654288889 |
Mailing Telephone | 7654288888 |
Mailing Fax Number | 7654288889 |
Enumeration Date | 2007-05-03 |
Last Update Date | 2014-06-27 |
Authorized Official Name | PHYLLIS M. WATKINS (BILLING DEPARTMENT) |
Authorized Official Telephone | 7654288888 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 207W00000X | Ophthalmology | 01057576A | IN | Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
IN | STATE LICENSE | 01057576A | 01 |
IN | RAILROAD MEDICARE | POO176469 | 01 |
IN | 200441070 | 05 |
Street Address |
1013 N 13TH ST |
City | LAFAYETTE |
State | IN |
Zip Code | 47904-2011 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1265458160 | Rodney B. Kusumi | Ophthalmology | 1013 N 13th St, Lafayette, IN 47904-2011 | 2006-07-14 |
1720387921 | Robert A Maines | Registered Nurse | 1013 N 13th St, Lafayette, IN 47904-2011 | 2011-03-28 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1568998615 | Angela Hands | Physical Therapy Assistant | 1260 North 17th Street, Lafayette, IN 47904 | 2017-05-11 |
1366894164 | Kathryn Barnett | Behavioral Analyst | 2785 Cason St # 2, Lafayette, IN 47904 | 2016-07-06 |
1881972917 | Rest Assured, LLC | Durable Medical Equipment & Medical Supplies | 180 Professional Ct., Lafayette, IN 47904 | 2011-07-22 |
1144514233 | Michelle Cristin Singleton | Dietitian, Registered | 508 N 26th St, Lafayette, IN 47904 | 2011-06-06 |
1912134438 | Jean D Trammel | Marriage & Family Therapist | 2000 Greenburg St, Bldg B, Suite A, Lafayette, IN 47904 | 2009-06-11 |
1902946056 | Terry Richard Baker | Optometrist | 2300 Sagamore Parkway S, Lafayette, IN 47904 | 2007-02-07 |
1891862165 | Becki A Bowditch Inc | Social Worker | 2201 Ferry Street, Lafayette, IN 47904 | 2006-11-29 |
1326121849 | James Lowell Thomas | Pediatrics | 2300 Ferry St, Lafayette, IN 47904 | 2006-10-21 |
1700976719 | Michael Leonard Bagnoli | Dentist | 2020 Union Street, Suite 200, Lafayette, IN 47904 | 2006-10-13 |
1255428801 | Lynn Arlen Pestle | Dentist | 2550 Elmwood Avenue, Lafayette, IN 47904 | 2006-10-06 |
Find all providers in zip 47904 |
Taxonomy Code | 207W00000X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Ophthalmology |
An ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses. |
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Ophthalmology, 2007. http://www.abop.org/. American Osteopathic Board of Ophthalmology and Otolaryngology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Ophthalmology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1043653439 | Emily Mcintosh Prouet | Ophthalmology | 155 Hospital Dr Ste 300, Lafayette, LA 70503 | 2013-04-16 |
1689930711 | William Manfred Adler | Ophthalmology | 3751 St. Francis Dr., Lafayette, CA 94549 | 2012-04-03 |
1295021160 | Kathleen M Williamson | Ophthalmology | 1400 Teal Rd Ste 8, Lafayette, IN 47905-2463 | 2011-06-20 |
1316106008 | Mary Summers | Ophthalmology | 5000 Ambassador Caffery Pkwy Bldg 13, Lafayette, LA 70508-6984 | 2008-06-06 |
1760649024 | Robert Jackson Courtney | Ophthalmology | 1050 W South Boulder Rd Ste 2100, Lafayette, CO 80026-2818 | 2008-05-22 |
1376733634 | Lebanon Eye Associates | Ophthalmology | 1051 Scottsville Rd, Lafayette, TN 37083-2213 | 2007-08-01 |
1013125079 | Anu Gupta Desai | Ophthalmology | 155 Hospital Drive, Suite 300, Lafayette, LA 70503 | 2007-05-21 |
1447475652 | Julie Larkin Foreman | Ophthalmology | 203 Rue Louis Xiv Ste A, Lafayette, LA 70508-5736 | 2007-04-13 |
1619045192 | Douglas S Conard | Ophthalmology | 214 N Farabee Drive, Lafayette, IN 47905 | 2006-12-01 |
1265458160 | Rodney B. Kusumi | Ophthalmology | 1013 N 13th St, Lafayette, IN 47904-2011 | 2006-07-14 |
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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.