Individual provider Active NPI

Charles Stanton Newman Jr., OD

  • Optometrist
  • Bay St Louis, MS
National Provider Identifier
1407957079
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
524 Issued in MS
Practice address
299 Hwy 90 East
Bay St Louis, MS 39520
Phone
(228) 467-1020
Fax
(228) 467-7258
NPI assigned
Sep 26, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 524 MS Primary

Addresses

Primary practice location

299 Hwy 90 East
Bay St Louis, MS 39520

Mailing address

299 Hwy 90 East
Bay St Louis, MS 39520
Phone (228) 467-1020

Other identifiers 1

IdentifierTypeStateIssuer
9013468MedicaidMS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
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

Enrollment IDStateProvider typePAC IDDetails
I20080630000048 MS Practitioner - Optometry 3870662455 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of Houston - College of Optometry, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

299 Hwy 90
Bay Saint Louis, MS 39520-3606
Phone (228) 461-1020

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Newman Eye Clinic Optometrist CurrentSince Jan 14, 1986 Accepting new patients
Newman Eye Clinic, PA Optometrist Past Accepting new patients

Locations

299 Highway 90
Bay St Louis, MS 39520
Phone (228) 467-1020

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1159228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1407957079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "299 HWY 90 EAST",
            "city": "BAY ST LOUIS",
            "state": "MS",
            "postal_code": "39520",
            "telephone_number": "228-467-1020",
            "fax_number": "228-467-7258"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "299 HWY 90 EAST",
            "city": "BAY ST LOUIS",
            "state": "MS",
            "postal_code": "39520",
            "telephone_number": "228-467-1020",
            "fax_number": "228-467-7258"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEWMAN",
        "first_name": "CHARLES",
        "middle_name": "STANTON",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MS",
            "license": "524",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9013468",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bay St Louis, MS

Sources for this page

Verify at the official NPI Registry.