Organization Active NPI

Retina & Vitreous of Louisiana, Inc.

  • Ophthalmology Physician
  • Baton Rouge, LA
National Provider Identifier
1285857607
Registry record updated Oct 11, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
021851 Issued in LA
Legal business name
RETINA & VITREOUS OF LOUISIANA, INC.
Practice address
10202 Jefferson Hwy Ste D
Baton Rouge, LA 70809-3183
Phone
(225) 768-8833
Fax
(225) 769-4839
NPI assigned
Apr 11, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2018

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

Authorized official

Name
John T. Couvillion, M.D.NPI 1497762207
Title
President
Phone
(225) 768-8833

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
Ophthalmology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207W00000X 021851 LA Primary

Addresses

Primary practice location

10202 Jefferson Hwy Ste D
Baton Rouge, LA 70809-3183

Mailing address

10202 Jefferson Hwy Ste D
Baton Rouge, LA 70809-3183
Phone (225) 768-8833

Other identifiers 1

IdentifierTypeStateIssuer
1009113MedicaidLA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041209000026 LA Part B Supplier - Clinic/Group Practice 7315903572 Receives reassigned benefits from 3 practitioners
Practice locations: Baton Rouge, LA

National Provider Directory

National Provider Directory

Locations

5615 Jackson St
#B
Alexandria, LA 71303

5615 Jackson Street Ext
#B
Alexandria, LA 71303
Phone (318) 442-7787

7777 Hennessy Blvd
Ste 606
Baton Rouge, LA 70808
Phone (225) 768-8833

7777 Hennessy Blvd
Ste 209
Baton Rouge, LA 70808
Phone (225) 768-8833

7777 Hennessy Blvd
Ste 501
Baton Rouge, LA 70808
Phone (225) 767-0822

10202 Jefferson Hwy
Baton Rouge, LA 70809
Phone (225) 768-8833

10202 Jefferson Hwy
Ste D
Baton Rouge, LA 70809
Phone (225) 768-8833

1600 Camellia Blvd
#B
Lafayette, LA 70508
Phone (337) 988-6442

20103 Old Scenic Hwy
Ste 2A
Zachary, LA 70791

20103 Old Scenic Hwy
Bldg 2A
Zachary, LA 70791

20103 Old Scenic Hwy
Ste A
Zachary, LA 70791
Phone (504) 481-0707

Interoperability endpoints

  • Direct secure messaging: wtorres@rvol.intellechartdirect.net

Practitioners & affiliated clinicians

Practitioners 8

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": "1176249600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1539216000000",
    "number": "1285857607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10202 JEFFERSON HWY STE D",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708093183",
            "telephone_number": "225-768-8833",
            "fax_number": "225-769-4839"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10202 JEFFERSON HWY STE D",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708093183",
            "telephone_number": "225-768-8833",
            "fax_number": "225-769-4839"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RETINA & VITREOUS OF LOUISIANA, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-11",
        "last_updated": "2018-10-11",
        "status": "A",
        "authorized_official_last_name": "COUVILLION",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "T.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "225-768-8833",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "LA",
            "license": "021851",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1009113",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Baton Rouge, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2018; 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.