Coosa Eye Associates, P.C.

Primary specialty

OptometristTaxonomy code 152W00000X

License

S-471-TA-079 Issued in AL

Legal business name

COOSA EYE ASSOCIATES, P.C.

Practice address

34011 US Highway 280
Childersburg, AL 35044-2128

Phone

(256) 378-5507

Fax

(256) 378-5325

NPI assigned

Nov 29, 2006

Last updated

Mar 6, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

P. Duncan Roy Jr., O.D.NPI 1508936014

Title

Owner

Phone

(256) 378-5507

Specialties & licenses 1

Addresses

Other identifiers 3

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• P. Duncan Roy Jr., O.D.

  • Optometrist
  • Childersburg, AL
  • NPI 1508936014
  Authorized official Same address or phone
• Young H Choi, M.D.

  • Ophthalmology Physician
  • Vestavia, AL
  • NPI 1780799684
  NPD

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

{
    "created_epoch": "1164758400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1330992000000",
    "number": "1053488544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX J",
            "city": "CHILDERSBURG",
            "state": "AL",
            "postal_code": "350440510",
            "telephone_number": "256-378-5507",
            "fax_number": "256-378-5325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34011 US HIGHWAY 280",
            "city": "CHILDERSBURG",
            "state": "AL",
            "postal_code": "350442128",
            "telephone_number": "256-378-5507",
            "fax_number": "256-378-5325"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COOSA EYE ASSOCIATES, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-29",
        "last_updated": "2012-03-06",
        "status": "A",
        "authorized_official_last_name": "ROY",
        "authorized_official_first_name": "P. DUNCAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "256-378-5507",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AL",
            "license": "S-471-TA-079",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000059662",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "510-59662",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID",
            "identifier": "102G703418",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Childersburg Family Dental
• Childersburg GR Dental, LLC (280 Dental Care)
• City of Childersburg (Childersburg Ambulance Service)
• Wendy White Cleveland, RPH
• Nikese D Coleman, MS, OTR/L
• Duncan Crowder, PT
• Margaret B Crowder, PT
• Troy Hanson Dennis, D.M.D.
• Dental Associates of Childersburg LLC
• Diabetic and Wound Care Management Services LLC

• Optometrist in Childersburg, AL
• Providers in Childersburg, AL by specialty
• Optometrist in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.