Eye Center of Denham Springs LLC

Primary specialty

OptometristTaxonomy code 152W00000X

License

1537-559T Issued in LA

Legal business name

EYE CENTER OF DENHAM SPRINGS LLC

Practice address

206 Petes Hwy
Denham Springs, LA 70726-3842

Phone

(225) 665-2828

Fax

(225) 665-2820

NPI assigned

Oct 1, 2008

Last updated

Jan 13, 2011By 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

Dr. Brandon Boyd Wax, O.D.NPI 1902815046

Title

Optometrist

Phone

(225) 665-2828

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in LA

Enrollment records 1

Locations

Practitioners 3

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.

• Brandon B Wax, OD

  • Optometrist
  • Oakdale, LA
  • NPI 1902815046
  Medicare reassignment NPD Authorized official
• Catherine Johnson, O.D.

  • Optometrist
  • Denham Springs, LA
  • NPI 1003225921
  Medicare reassignment NPD
• Reshma Amin, O.D.

  • Optometrist
  • Baton Rouge, LA
  • NPI 1144455726
  NPD (past)

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

{
    "created_epoch": "1222819200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1294876800000",
    "number": "1083865794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "206 PETES HWY",
            "city": "DENHAM SPRINGS",
            "state": "LA",
            "postal_code": "707263842",
            "telephone_number": "225-665-2828",
            "fax_number": "225-665-2820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "206 PETES HWY",
            "city": "DENHAM SPRINGS",
            "state": "LA",
            "postal_code": "707263842",
            "telephone_number": "225-665-2828",
            "fax_number": "225-665-2820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYE CENTER OF DENHAM SPRINGS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-01",
        "last_updated": "2011-01-13",
        "status": "A",
        "authorized_official_last_name": "WAX",
        "authorized_official_first_name": "BRANDON",
        "authorized_official_middle_name": "BOYD",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "225-665-2828",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "LA",
            "license": "1537-559T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1509337",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS AND BLUE SHEILD OF LA",
            "identifier": "1083865794",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Optometrist in Denham Springs, LA
• Providers in Denham Springs, LA by specialty
• Optometrist in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.