DR. RICKY LEE WEIDOW O.D. NPI 1639177793

NPI Information

  • NPI: 1639177793
  • Provider Name: DR. RICKY LEE WEIDOW, O.D.
  • Classification: Optometrist - 152W00000X
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 201 W WAYNE ST
    LAGRANGE, IN
    ZIP 46761
  • Phone: (260) 463-3421

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NPI Details

DR. Ricky Lee Weidow, O.D. is an optometrist in Lagrange, IN with 33 years of experience. The provider is 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. DR. Ricky Lee Weidow, O.D. NPI is 1639177793. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: SOUTHERN COLLEGE OF OPTOMETRY
Graduation Year:1993

The provider's business location address is:

201 W WAYNE ST
LAGRANGE, IN
ZIP 46761-850
Phone: (260) 463-3421
Fax: (260) 463-7347

The NPI 1639177793 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA).

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Established patient office or other outpatient visit, 20-29 minutes (HCPCS:99213)
  • Exam of visual field with extended testing (HCPCS:92083)
  • Imaging of retina (HCPCS:92134)
  • Photography of the retina (HCPCS:92250)

The enumeration date for this NPI number is 7/12/2005 and was last updated on 2/14/2010.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1152WC0802XOptometristCorneal and Contact Management18002670A/BINDIANANo
2152WP0200XOptometristPediatrics18002670A/BINDIANANo
3152W00000XOptometrist18002670A/BINDIANAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1000000635212OTHERINDIANAANTHEM BC/BS NWIELC KNOX
24002320002MEDICARE NSCINDIANA
3180230MEDICARE PININDIANA
4410043915MEDICARE PININDIANA
5169220AMEDICARE PININDIANA
6169230AMEDICARE PININDIANA
7000000257712OTHERINDIANAANTHEM BC/BS TOPEKA
8200097680EMEDICAIDINDIANA
94002320001MEDICARE NSCINDIANA
105742334109OTHERINDIANAVISION SERVICE PLAN SOUTH BEND
11U62249MEDICARE UPININDIANA
12410043916MEDICARE PININDIANA
13461830AMEDICARE PININDIANA
14000000257711OTHERINDIANAANTHEM BC/BS LAGRANGE
152605932505OTHERINDIANAVISION SERVICE PLAN TOPEKA
162604633421OTHERINDIANAVISION SERVICE PLAN LAGRANGE
17200097680DMEDICAIDINDIANA
18461830MEDICARE PININDIANA
191174740682OTHERINDIANARENAISSANCE OCULAR DISEASE AND TRAUMA FOUNDATION TYPE 2 GROUP NPI
20200097680CMEDICAIDINDIANA
21169220MEDICARE PININDIANA
22169230MEDICARE PININDIANA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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