Charles Gordon Stevenson III, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

OP0002311 Issued in FL

Practice address

770 Hwy 331 South
Suite 1
Defuniak Springs, FL 32435

Phone

(850) 892-5514

Fax

(850) 892-0189

NPI assigned

Oct 23, 2006

Last updated

Sep 25, 2008By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

University Alabama Birmingham - School of Optometry, 1988

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Vision Hub LLCGroup PAC ID 7214330786, 7 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as individual

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Chuck Stevenson OD PA

  • Optometrist
  • Defuniak Springs, FL
  • NPI 1962703009
  Medicare reassignment NPD Authorized official
• The Vision Hub LLC

  dba The Vision Hub at Defuniak Springs

  • Optometrist
  • Defuniak Springs, FL
  • NPI 1720652316
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1161561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1222300800000",
    "number": "1003999756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1289",
            "city": "DEFUNIAK SPRINGS",
            "state": "FL",
            "postal_code": "32435",
            "telephone_number": "850-892-5514",
            "fax_number": "850-892-0189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "770 HWY 331 SOUTH",
            "address_2": "SUITE 1",
            "city": "DEFUNIAK SPRINGS",
            "state": "FL",
            "postal_code": "32435",
            "telephone_number": "850-892-5514",
            "fax_number": "850-892-0189"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEVENSON",
        "first_name": "CHARLES",
        "middle_name": "GORDON",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-23",
        "last_updated": "2008-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OP0002311",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "084170600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Optometrist in Defuniak Springs, FL
• Providers in Defuniak Springs, FL by specialty
• Optometrist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.