Individual provider Active NPI

Steven R Landreth, OD

  • Optometrist
  • Northport, AL
National Provider Identifier
1083828545
Registry record updated Jan 13, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
S914TA467 Issued in AL
Practice address
3519 Watermelon Rd
Northport, AL 35473-5174
Phone
(205) 758-0242
NPI assigned
May 10, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X S914TA467 AL Primary

Addresses

Primary practice location

3519 Watermelon Rd
Northport, AL 35473-5174

Mailing address

1655 McFarland Blvd N
Suite 127
Tuscaloosa, AL 35406-2212
Phone (205) 758-0242

Other identifiers 2

IdentifierTypeStateIssuer
051554102MedicaidAL
51500676OtherALBCBS OF AL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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
I20080503000048 AL Practitioner - Optometry 1153409602 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University Alabama Birmingham - School of Optometry, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Landreth and Associates IncGroup PAC ID 1850479684, 3 clinicians

Practice addresses (Care Compare)

3519 Watermelon Rd
Northport, AL 35473-5174
Phone (205) 758-0242

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery12

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
S914TA467ALMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Landreth & Associates Inc Optometrist CurrentSince Jun 1, 2000 Accepting new patients
Landreth & Associates Inc Optometrist Current Accepting new patients

Locations

703 Tuscaloosa St
Greensboro, AL 36744

3519 Watermelon Rd
Northport, AL 35473
Phone (205) 345-1520

206 1st Ave E
Reform, AL 35481

311 1st St S
Reform, AL 35481
Phone (205) 375-8200

1655 McFarland Blvd N
Tuscaloosa, AL 35406
Phone (205) 301-8930

Interoperability endpoints

  • Direct secure messaging: stevenlandreth@direct.revolutionehr.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1178755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1294876800000",
    "number": "1083828545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1655 MCFARLAND BLVD N",
            "address_2": "SUITE 127",
            "city": "TUSCALOOSA",
            "state": "AL",
            "postal_code": "354062212",
            "telephone_number": "205-758-0242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3519 WATERMELON RD",
            "city": "NORTHPORT",
            "state": "AL",
            "postal_code": "354735174",
            "telephone_number": "205-758-0242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANDRETH",
        "first_name": "STEVEN",
        "middle_name": "R",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-10",
        "last_updated": "2011-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AL",
            "license": "S914TA467",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "051554102",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF AL",
            "identifier": "51500676",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Northport, AL

Sources for this page

Verify at the official NPI Registry.