NPIMap

Organization Active NPI

Timothy J Leach OD a Professional Optometrist Corporation

  • Optometrist
  • Metairie, LA
National Provider Identifier
1306116462
Registry record updated Jun 13, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1241-391T Issued in LA
Legal business name
TIMOTHY J LEACH OD A PROFESSIONAL OPTOMETRIST CORPORATION
Practice address
3200 Severn Ave
Suite 102
Metairie, LA 70002-4791
Phone
(504) 887-2020
Fax
(504) 887-7698
NPI assigned
Jan 6, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2012

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

Authorized official

Name
Mrs. Janet Duplessis
Title
Insurance Administrator
Phone
(504) 247-9116

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 1241-391T LA Primary

Addresses

Primary practice location

3200 Severn Ave
Suite 102
Metairie, LA 70002-4791

Mailing address

3200 Severn Ave
Suite 102
Metairie, LA 70002-4791
Phone (504) 887-2020

Other names 1

  • ST CHARLES VISION SEVERN Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1325808000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1339545600000",
    "number": "1306116462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3200 SEVERN AVE",
            "address_2": "SUITE 102",
            "city": "METAIRIE",
            "state": "LA",
            "postal_code": "700024791",
            "telephone_number": "504-887-2020",
            "fax_number": "504-887-7698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3200 SEVERN AVE",
            "address_2": "SUITE 102",
            "city": "METAIRIE",
            "state": "LA",
            "postal_code": "700024791",
            "telephone_number": "504-887-2020",
            "fax_number": "504-887-7698"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TIMOTHY J LEACH OD A PROFESSIONAL OPTOMETRIST CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-06",
        "last_updated": "2012-06-13",
        "status": "A",
        "authorized_official_last_name": "DUPLESSIS",
        "authorized_official_first_name": "JANET",
        "authorized_official_title_or_position": "INSURANCE ADMINISTRATOR",
        "authorized_official_telephone_number": "504-247-9116",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "LA",
            "license": "1241-391T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ST CHARLES VISION SEVERN",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Metairie, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.