Eye Laser & Surgery Center of Columbus, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

EYE LASER & SURGERY CENTER OF COLUMBUS, LLC

Practice address

634 Leigh Dr
Columbus, MS 39705-3014

Phone

(662) 327-3773

Fax

(662) 327-3996

NPI assigned

Oct 7, 2005

Last updated

Jul 20, 2007By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Renee Owen, R.N.

Title

Clinical Director

Phone

(662) 327-3773

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MS

Enrollment records 1

Listed as

Eye Laser and Surgery Center of Columbus LLCCCN 25C0001039

Medicare certification status

ActiveFrom the Provider of Services file

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Practitioners 2

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.

• James Daniel Bennett III, M.D.

  • Ophthalmology Physician
  • Columbus, MS
  • NPI 1871596130
  NPD (past)
• William Meek Gillespie III, M.D.

  • Ophthalmology Physician
  • Columbus, MS
  • NPI 1366445520
  NPD (past)

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

{
    "created_epoch": "1128643200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1184889600000",
    "number": "1396733945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "634 LEIGH DR",
            "city": "COLUMBUS",
            "state": "MS",
            "postal_code": "397053014",
            "telephone_number": "662-327-3773",
            "fax_number": "662-327-3996"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "634 LEIGH DR",
            "city": "COLUMBUS",
            "state": "MS",
            "postal_code": "397053014",
            "telephone_number": "662-327-3773",
            "fax_number": "662-327-3996"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYE LASER & SURGERY CENTER OF COLUMBUS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-07",
        "last_updated": "2007-07-20",
        "status": "A",
        "authorized_official_last_name": "OWEN",
        "authorized_official_first_name": "RENEE",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "662-327-3773",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "R.N."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "MS",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00770586",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Anna Evans, APRN
• Doria Johnson Evans
• Amanda Everett, NP-C
• Every Care Matters LLC
• Evolutions on Fifth, LLC (Mississippi Mobile Vaccination Clinic)
• Family Friend,LLC
• Peyton Fandel, DPT
• Farris Family Dentistry PLLC (Ascent Dental)
• C. Chance Farris, DMD
• Father's Child Ministry

• Ambulatory Surgical Clinic/Center in Columbus, MS
• Providers in Columbus, MS by specialty
• Ambulatory Surgical Clinic/Center in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.