St. Charles Vision Outlet Elmwood, LLC

Primary specialty

OptometristTaxonomy code 152W00000X

License

1079242T Issued in LA

Legal business name

ST. CHARLES VISION OUTLET ELMWOOD, LLC

Doing business as

St. Charles Vision Elmwood

Practice address

837 S Clearview Pkwy
Jefferson, LA 70121-3119

Phone

(504) 733-0406

Fax

(504) 733-0801

NPI assigned

Dec 13, 2005

Organization subpart

No

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

Authorized official

Name

Mrs. Janet Duplessis

Title

Insurance Administrator

Phone

(504) 247-9116

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• ST. CHARLES VISION ELMWOOD Doing business as

Locations

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

{
    "created_epoch": "1134432000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1339545600000",
    "number": "1114902251",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "837 S CLEARVIEW PKWY",
            "city": "JEFFERSON",
            "state": "LA",
            "postal_code": "701213119",
            "telephone_number": "504-733-0406",
            "fax_number": "504-733-0801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "837 S CLEARVIEW PKWY",
            "city": "JEFFERSON",
            "state": "LA",
            "postal_code": "701213119",
            "telephone_number": "504-733-0406",
            "fax_number": "504-733-0801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. CHARLES VISION OUTLET ELMWOOD, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-13",
        "last_updated": "2012-06-13",
        "status": "A",
        "authorized_official_last_name": "DUPLESSIS",
        "authorized_official_first_name": "JANET",
        "authorized_official_title_or_position": "INSURANCE ADMINISTRATOR",
        "authorized_official_telephone_number": "504-247-9116",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "LA",
            "license": "1079242T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "410026332",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ST. CHARLES VISION ELMWOOD",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Rebecca Lindsay Snyder, MPH, RD, LDN
• Warren Ray Ramil Solon, MSN, APRN, AGACNP-BC
• Kayla Sosa, FNP-C
• Tara P Sosa
• Southern Rehab & Medical Center
• Katherine Stagno, A.T.C
• Madeline Stanford, DO
• Melissa Hahn Stano, NP
• Kristen Gilberti Stevens, NP
• Brad Steverson, ATC

• Optometrist in Jefferson, LA
• Providers in Jefferson, LA by specialty
• Optometrist in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 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.