Individual provider Active NPI

Dellia Salone Evans, O.D.

  • Optometrist
  • Jackson, MS
National Provider Identifier
1164457941
Registry record updated May 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
677 Issued in MS
Practice address
1461 Canton Mart Rd Ste a
Jackson, MS 39211-5413
Phone
(601) 977-0835
Fax
(601) 977-0689
NPI assigned
Jul 11, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 17, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 677 MS Primary

Addresses

Primary practice location

1461 Canton Mart Rd Ste a
Jackson, MS 39211-5413

Mailing address

1461 Canton Mart Rd Ste a
Jackson, MS 39211-5413
Phone (601) 977-0835

Other identifiers 1

IdentifierTypeStateIssuer
02735526MedicaidMS

Other names 1

  • Dr. Dellia Salone Evans Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
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
I20040223000766 MS Practitioner - Optometry 7618863101 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University Alabama Birmingham - School of Optometry, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1461 Canton Mart Rd
Suite a
Jackson, MS 39211-5413
Phone (601) 977-0272

1860 Chadwick Dr
Suite 103
Jackson, MS 39204-3465
Phone (601) 373-0714

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery21

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Dr. D. Salone McKinney and Associates Optometrist CurrentSince Jun 23, 2004 Accepting new patients
Odoms Eye Care Central Optometrist CurrentSince Oct 8, 2022 Accepting new patients
Odoms Eye Care, PLLC Optometrist CurrentSince Mar 1, 2011 Accepting new patients
Canton Vision Clinic, P.a. Optometrist Past Accepting new patients
Dr Charles J Bell and Associates Optometrist Past Accepting new patients
Dr Mary C Bell and Associates, PC Past Accepting new patients
Optical 2000 of Flora PA Optometrist Past Accepting new patients
Optical 2000 Optometrist PastSince Jul 12, 2005 Accepting new patients
Professional Eyecare Associates ,Inc Optometrist Past Accepting new patients

Locations

1461 Canton Mart Rd
Ste E
Jackson, MS 39211
Phone (601) 954-8778

1860 Chadwick Dr
Ste 103
Jackson, MS 39204
Phone (601) 202-2938

1461 Canton Mart Rd
Ste A
Jackson, MS 39211
Phone (601) 977-0272

Organizations & group practices 9

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": "1152576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652745600000",
    "number": "1164457941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1461 CANTON MART RD STE A",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392115413",
            "telephone_number": "601-977-0835",
            "fax_number": "601-977-0689"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1461 CANTON MART RD STE A",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392115413",
            "telephone_number": "601-977-0835",
            "fax_number": "601-977-0689"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVANS",
        "first_name": "DELLIA",
        "middle_name": "SALONE",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-11",
        "last_updated": "2022-05-17",
        "certification_date": "2022-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MS",
            "license": "677",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02735526",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DELLIA",
            "last_name": "EVANS",
            "middle_name": "SALONE",
            "prefix": "DR.",
            "credential": "OD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Jackson, MS

Sources for this page

Verify at the official NPI Registry.