Organization Active NPI

Coast Eyes PLLC

  • Optometrist
  • D'Iberville, MS
National Provider Identifier
1114223823
Registry record updated Jan 28, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
755 Issued in MS
Legal business name
COAST EYES PLLC
Practice address
3887 Promenade Pkwy
Suite C
D'Iberville, MS 39540-5379
Phone
(228) 392-8141
Fax
(228) 392-8181
NPI assigned
Jan 28, 2011
Last updated
Jan 28, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2011

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

Authorized official

Name
Dr. Scott Sanders, O.D.NPI 1558431163
Title
Sole Member
Phone
(228) 392-8141

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 755 MS Primary

Addresses

Primary practice location

3887 Promenade Pkwy
Suite C
D'Iberville, MS 39540-5379

Mailing address

3887 Promenade Pkwy
Suite C
D'Iberville, MS 39540-5379
Phone (228) 392-8141

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110304000060 MS Part B Supplier - Clinic/Group Practice 6103008693 Receives reassigned benefits from 3 practitioners
Practice locations: Diberville, MS

National Provider Directory

National Provider Directory

Locations

3821 Promenade Pkwy
Ste D
Diberville, MS 39540
Phone (228) 392-8141

3821 Promenade Pkwy
Ste F
Diberville, MS 39540
Phone (228) 392-8141

3887 Promenade Pkwy
Ste C
Diberville, MS 39540
Phone (228) 392-8141

4233 W Gay Rd
Ste 101
Diberville, MS 39540
Phone (228) 392-8141

4233 W Gay Rd
Ste A
Diberville, MS 39540
Phone (228) 392-8141

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1296172800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1296172800000",
    "number": "1114223823",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3887 PROMENADE PKWY",
            "address_2": "SUITE C",
            "city": "D'IBERVILLE",
            "state": "MS",
            "postal_code": "395405379",
            "telephone_number": "228-392-8141",
            "fax_number": "228-392-8181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3887 PROMENADE PKWY",
            "address_2": "SUITE C",
            "city": "D'IBERVILLE",
            "state": "MS",
            "postal_code": "395405379",
            "telephone_number": "228-392-8141",
            "fax_number": "228-392-8181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COAST EYES PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-01-28",
        "last_updated": "2011-01-28",
        "status": "A",
        "authorized_official_last_name": "SANDERS",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_title_or_position": "SOLE MEMBER",
        "authorized_official_telephone_number": "228-392-8141",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MS",
            "license": "755",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in D'Iberville, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 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.