Active NPI
Accurate Eye Care LLC
- Ophthalmology Physician
- Thibodaux, LA
National Provider Identifier
1144418484
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ophthalmology Physician
- License
- 12816R
- Legal business name
- ACCURATE EYE CARE LLC
- Practice address
- 900 Canal Blvd
Suite 3
Thibodaux, LA 70301-4506 - Phone
- (985) 448-3353
- Fax
- (985) 448-1276
- NPI assigned
- Oct 11, 2007
- Last updated
- May 15, 2024
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Keith E Kellum, M.D.
- Title
- Sole Owner
- Phone
- (985) 448-3353
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Ophthalmology Physician | 207W00000X | 12816R | LA | Primary |
Addresses
Primary practice location
900 Canal Blvd
Suite 3
Thibodaux, LA 70301-4506
Mailing address
900 Canal Blvd
Suite 3
Thibodaux, LA 70301-4506
Phone (985) 448-3353
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4373997980 | Other | LA | BLUECROSS BLUE SHIELD |
| 1574155 | Medicaid | LA | |
| P00155035 | Other | LA | RAILROAD MEDICARE |
| 0007025369 | Other | LA | AETNA INS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in LA
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040726000360 | LA | Part B Supplier - Clinic/Group Practice | 2264412667 |
Receives reassigned benefits from 6 practitioners Practice locations: Houma, LA; Thibodaux, LA |
| O20100930022047 | LA | DME Supplier - Physician - Ophthalmology | 2264412667 | Practice locations: Thibodaux, LA |
Other NPIs with the same Medicare PAC ID 1
NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).
National Provider Directory
National Provider Directory- Tax ID family
- Accurate Eye Care LLC
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
Locations
900 Canal Blvd
Ste 3
Thibodaux, LA 70301
Phone (985) 448-3353
Practitioners & affiliated clinicians
Practitioners 6
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.
-
- Ophthalmology Physician
- Houma, LA
- NPI 1225036023
-
- Optometrist
- Houma, LA
- NPI 1114755709
-
- Optometrist
- Boutte, LA
- NPI 1609122217
-
- Ophthalmology Physician
- Thibodaux, LA
- NPI 1366527756
-
- Optometrist
- Houma, LA
- NPI 1073563433
-
- Ophthalmology Physician
- New Orleans, LA
- NPI 1215202551
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1192060800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1715731200000",
"number": "1144418484",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "900 CANAL BLVD",
"address_2": "SUITE 3",
"city": "THIBODAUX",
"state": "LA",
"postal_code": "703014506",
"telephone_number": "985-448-3353",
"fax_number": "985-448-1276"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "900 CANAL BLVD",
"address_2": "SUITE 3",
"city": "THIBODAUX",
"state": "LA",
"postal_code": "703014506",
"telephone_number": "985-448-3353",
"fax_number": "985-448-1276"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ACCURATE EYE CARE LLC",
"organizational_subpart": "NO",
"enumeration_date": "2007-10-11",
"last_updated": "2024-05-15",
"certification_date": "2024-05-15",
"status": "A",
"authorized_official_last_name": "KELLUM",
"authorized_official_first_name": "KEITH",
"authorized_official_middle_name": "E",
"authorized_official_title_or_position": "SOLE OWNER",
"authorized_official_telephone_number": "985-448-3353",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "M.D."
},
"taxonomies": [
{
"code": "207W00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Ophthalmology",
"state": "LA",
"license": "12816R",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUECROSS BLUE SHIELD",
"identifier": "4373997980",
"state": "LA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1574155",
"state": "LA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "P00155035",
"state": "LA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA INS",
"identifier": "0007025369",
"state": "LA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Thibodaux, LA
- Abundant Health Medical Clinic, LLC (Abundant Health Medical Clinic)
- Acadia Dermatology and Aesthetic Center, LLC
- Acadia Family Dentistry
- Acadian Chiroprctic and Rehab LLC
- Access Health Louisiana
- Clel Louis Acosta, MD
- Vicky Acosta
- Acute Care Clinic (Family Doctors of Louisiana)
- Danielle R Adam, ATC, LAT, CPHT
- Alexis Adams
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2024; 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.