Individual provider Active NPI

Christine M Davis, OD

  • Optometrist
  • Shreveport, LA
National Provider Identifier
1033182183
Registry record updated Oct 19, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1892-828AT Issued in LA
Practice address
955 Pierremont Rd Ste 400
Shreveport, LA 71106-2096
Phone
(318) 868-6118
Fax
(318) 666-9927
NPI assigned
Feb 9, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 19, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1892-828AT LA Primary

Addresses

Primary practice location

955 Pierremont Rd Ste 400
Shreveport, LA 71106-2096

Mailing address

955 Pierremont Rd Ste 400
Shreveport, LA 71106-2096
Phone (318) 868-6118

Other identifiers 2

IdentifierTypeStateIssuer
2505882MedicaidLA
847833OtherLAMEDICARE

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address drdavisod@icloud.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE, LA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20150406001215 NE Practitioner - Optometry 6901718071 Practice locations: Omaha, NE
I20190906001150 LA Practitioner - Optometry 6901718071 Reassigns benefits to 1 organization
Practice locations: Shreveport, LA

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
New England College of Optometry, 1998
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

955 Pierremont Rd
Suite 400
Shreveport, LA 71106-2096
Phone (318) 868-6118

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1411NEMDClinical Social Worker
1892-828ATLAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Look Eyecare LLC Optometrist CurrentSince Oct 9, 2021 Accepting new patients

Locations

1812 Roselawn Ave
Monroe, LA 71201
Phone (318) 387-1602

955 Pierremont Rd
Ste 400
Shreveport, LA 71106
Phone (315) 562-3868

5848 Line Ave
Shreveport, LA 71106
Phone (318) 865-0017

15655 Pacific St
Ste 101
Omaha, NE 68118
Phone (402) 309-9244

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1139443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603065600000",
    "number": "1033182183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "955 PIERREMONT RD STE 400",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711062096",
            "telephone_number": "318-868-6118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "955 PIERREMONT RD STE 400",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711062096",
            "telephone_number": "318-868-6118",
            "fax_number": "318-666-9927"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "CHRISTINE",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-02-09",
        "last_updated": "2020-10-19",
        "certification_date": "2020-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "LA",
            "license": "1892-828AT",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2505882",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "847833",
            "state": "LA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "drdavisod@icloud.com",
            "affiliation": "N",
            "address_1": "955 Pierremont Rd Ste 400",
            "city": "Shreveport",
            "state": "LA",
            "country_code": "US",
            "postal_code": "711062096",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Shreveport, LA

Sources for this page

Verify at the official NPI Registry.