Cenla Vision Source, LLC
Organization Active NPI Optometrist · Alexandria, LA
NPI 1295558351 · NPPES record last updated Nov 6, 2024
Key facts
- NPI
- 1295558351
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Optometrist 152W00000X
- Legal business name
- CENLA VISION SOURCE, LLC
- Practice address
- 5615B Jackson St
Alexandria, LA 71303-2275 - Phone
- (318) 442-7787
- Fax
- (318) 443-1654
- NPI assigned
- Nov 6, 2024
- Organization subpart
- No
Authorized official
- Name
- Alayna Jordan Brown, OD
- Title
- Owner/Provider
- Phone
- (318) 442-7787
Practitioners 5
-
Lacy B Shaw, O.D.
-
Benjamin Hieu Vu, O.D.
-
Khanh Nghi Trinh, O.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in LA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20241231000110 | LA | Part B Supplier - Clinic/Group Practice | 8426585530 |
Receives reassigned benefits from 1 practitioner Practice locations: Alexandria, LA |
National Provider Directory
Locations
5615B Jackson Street Ext
Alexandria, LA 71303
Phone (318) 442-7787
5615 Jackson Street Ext
#101
Alexandria, LA 71303
5615 Jackson St
#101
Alexandria, LA 71303
Phone (318) 442-7787
5615 Jackson Street Ext
#101B
Alexandria, LA 71303
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist |
152W00000X | Yes |
Addresses
Primary practice location
5615B Jackson St
Alexandria, LA 71303-2275
Mailing address
5615B Jackson St
Alexandria, LA 71303-2275
Phone (318) 442-7787
Other names
- Cenla Vision Source
Other providers in Alexandria, LA
- Cenla Physicians Wound Care
- Cenla Professional Counseling
- Cenla Psychiatry, LLC
- Cenla Urgent Care LLC
- Cenla Urology Clinic LLC
- Cenla Wellness Center, LLC.
- Center for Family & Individual Counseling, Inc.
- Central la Human Services District
- Central la. Family Health and Wellness Center
- Central Louisiana 'Cenla' Neurology LLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 6, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.