Dallas Stevens

Primary specialty

OptometristTaxonomy code 152W00000X

License

ODP-100186 Issued in ID

Practice address

1232 Pleasantview
Rexburg, ID 83440-5316

Phone

(208) 709-7314

NPI assigned

Oct 21, 2008

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in ID

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

Specialty

Optometry

Education

Pacific Medical College, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Luke a. Randall PLLCGroup PAC ID 2365623311, 2 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Luke a. Randall PLLC

  • Optometrist
  • Boise, ID
  • NPI 1184925737
  Medicare reassignment Care Compare group NPD
• Ankle & Foot Medical Center PC

  • Foot & Ankle Surgery Podiatrist
  • Boise, ID
  • NPI 1093135634
  NPD
• Southern Idaho Vision Alliance,PLLC

  • Optometrist
  • Twin Falls, ID
  • NPI 1427169416
  NPD (past)

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

{
    "created_epoch": "1224547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588291200000",
    "number": "1174775332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4255 W SUGARBERRY CT",
            "city": "EAGLE",
            "state": "ID",
            "postal_code": "836167266",
            "telephone_number": "208-709-7314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1232 PLEASANTVIEW",
            "city": "REXBURG",
            "state": "ID",
            "postal_code": "834405316",
            "telephone_number": "208-709-7314"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEVENS",
        "first_name": "DALLAS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-10-21",
        "last_updated": "2020-05-01",
        "certification_date": "2020-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "ID",
            "license": "ODP-100186",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tate Coltan Staker, PA-C
• Cameron Stephenson, NP
• Elizabeth Clark Stephenson, LCPC
• Steps Inc.
• Sterling Provider Group
• James R Stevenson, RPH
• Kayla Stevenson, RN
• Karen Jannette Stewart, MOTR/L
• Courtney I Stimpson, LCSW
• Emily L Stirling, PHARMD

• Optometrist in Rexburg, ID
• Providers in Rexburg, ID by specialty
• Optometrist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.