Individual provider Active NPI

Thomas R Fairley, O.D.

  • Optometrist
  • Baton Rouge, LA
National Provider Identifier
1023046158
Registry record updated Dec 7, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1220-389T Issued in LA
Practice address
9001 Summa Ave
Baton Rouge, LA 70809-3726
Phone
(225) 761-5200
Fax
(225) 761-5618
NPI assigned
Jun 29, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1220-389T LA Primary

Addresses

Primary practice location

9001 Summa Ave
Baton Rouge, LA 70809-3726

Mailing address

9001 Summa Ave
Baton Rouge, LA 70809-3726
Phone (225) 761-5200

Other identifiers 1

IdentifierTypeStateIssuer
1693308MedicaidLA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
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

Enrollment IDStateProvider typePAC IDDetails
I20100108000457 LA Practitioner - Optometry 1658412945 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of Houston - College of Optometry, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ochsner Clinic LLCGroup PAC ID 8224933619, 2,845 clinicians

Practice addresses (Care Compare)

104 Acadia Park Dr
Raceland, LA 70394-2618
Phone (985) 537-3211

16777 Medical Ctr Dr
Baton Rouge, LA 70816-3254
Phone (225) 754-3278

Hospital & facility affiliations

  • Ochsner Medical Center - Baton Rouge Hospital, Baton Rouge, LA, CCN 190202
  • Our Lady of the Lake Regional Medical Center Hospital, Baton Rouge, LA, CCN 190064
  • Baton Rouge General Medical Center Hospital, Baton Rouge, LA, CCN 190065

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Ochsner Clinic LLC CurrentSince Aug 19, 1996 Accepting new patients
Ochsner Clinic LLC CurrentSince Aug 19, 1996 Accepting new patients

Locations

16777 Medical Center Dr
Baton Rouge, LA 70816
Phone (225) 754-3278

10310 The Grove Blvd
Baton Rouge, LA 70836
Phone (225) 761-5239

9001 Summa Ave
Baton Rouge, LA 70809

1514 Jefferson Hwy
New Orleans, LA 70121

104 Acadia Park Dr
Raceland, LA 70394
Phone (985) 537-3211

Interoperability endpoints

  • Direct secure messaging: tfairley12628@direct.ochsner.org

Organizations & group practices 2

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

Hospital & facility affiliations 8

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1151539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196985600000",
    "number": "1023046158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9001 SUMMA AVE",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708093726",
            "telephone_number": "225-761-5200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9001 SUMMA AVE",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708093726",
            "telephone_number": "225-761-5200",
            "fax_number": "225-761-5618"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAIRLEY",
        "first_name": "THOMAS",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-29",
        "last_updated": "2007-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "LA",
            "license": "1220-389T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1693308",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Baton Rouge, LA

Sources for this page

Verify at the official NPI Registry.