NPIMap

Organization Active NPI

Lopasteeda Derosa Stephens

  • Optometrist
  • McMinnville, TN
National Provider Identifier
1366844763
Registry record updated Sep 17, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OD0000001363 Issued in TN
Legal business name
LOPASTEEDA DEROSA STEPHENS
Practice address
1035 Smithville Hwy
McMinnville, TN 37110-1691
Phone
(931) 473-6865
NPI assigned
Sep 17, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2014

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

Authorized official

Name
Lopasteeda Derosa StephensNPI 1972507317
Title
Owner
Phone
(931) 473-6865

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
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X OD0000001363 TN Primary

Addresses

Primary practice location

1035 Smithville Hwy
McMinnville, TN 37110-1691

Mailing address

PO Box 308
McMinnville, TN 37111-0308

National Provider Directory

National Provider Directory

Locations

1035 Smithville Hwy
McMinnville, TN 37110
Phone (931) 473-6865

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1410912000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1410912000000",
    "number": "1366844763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 308",
            "city": "MCMINNVILLE",
            "state": "TN",
            "postal_code": "371110308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1035 SMITHVILLE HWY",
            "city": "MCMINNVILLE",
            "state": "TN",
            "postal_code": "371101691",
            "telephone_number": "931-473-6865"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOPASTEEDA DEROSA STEPHENS",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-17",
        "last_updated": "2014-09-17",
        "status": "A",
        "authorized_official_last_name": "STEPHENS",
        "authorized_official_first_name": "LOPASTEEDA",
        "authorized_official_middle_name": "DEROSA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "931-473-6865"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "TN",
            "license": "OD0000001363",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in McMinnville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2014; 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.