Glenn Coullard, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

683333T Issued in LA

Practice address

2421 Church St
Zachary, LA 70791-2710

Phone

(225) 654-1061

Fax

(225) 654-0791

NPI assigned

Mar 21, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in LA

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

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• C J Pollet, O.D., Inc

  • Health Service Clinic/Center
  • Mandeville, LA
  • NPI 1194091710
  Medicare reassignment NPD
• Vision Optique Inc

  • Optician
  • Mandeville, LA
  • NPI 1134152408

  Optometrist

  Medicare reassignment NPD
• Eye Care, Inc

  • Eyewear Supplier
  • Zachary, LA
  • NPI 1952474942
  NPD (past) Authorized official

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

{
    "created_epoch": "1142899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1344297600000",
    "number": "1346209236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2421 CHURCH ST",
            "city": "ZACHARY",
            "state": "LA",
            "postal_code": "707912710",
            "telephone_number": "225-654-1061",
            "fax_number": "225-654-0791"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2421 CHURCH ST",
            "city": "ZACHARY",
            "state": "LA",
            "postal_code": "707912710",
            "telephone_number": "225-654-1061",
            "fax_number": "225-654-0791"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COULLARD",
        "first_name": "GLENN",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-21",
        "last_updated": "2012-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "LA",
            "license": "683333T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1135411",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Corereach Technologies and Consulting LLC
• Jenna Cornes, MSOT
• Michelle F Cosse, MD
• Norah Lynettey Cossett
• Hanna Elizabeth Couch
• Erica Lesa Courtney
• Aerin Maylise Couvillion, L.AC, ACA
• Pamela Craig, M.ED., L-SLP,CCC-SLP
• Cristel Crain
• Patrick Chandler Crain

• Optometrist in Zachary, LA
• Providers in Zachary, LA by specialty
• Optometrist in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2012; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.