NPIMap

Organization Active NPI

Alexandria Eye and Laser Center, LLC

  • Optometrist
  • Leesville, LA
National Provider Identifier
1447429022
Registry record updated Jan 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
ALEXANDRIA EYE AND LASER CENTER, LLC
Practice address
1008 S 6TH St
Leesville, LA 71446-4920
Phone
(337) 392-1994
Fax
(337) 392-1944
NPI assigned
Feb 27, 2008
Last updated
Jan 10, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2025

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

Authorized official

Name
Octavia Jackson Williams
Title
Credentialing Specialist
Phone
(318) 561-0946

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X NU Primary
Ophthalmology Physician 207W00000X NU

Addresses

Primary practice location

1008 S 6TH St
Leesville, LA 71446-4920

Mailing address

231 Windermere Blvd
Alexandria, LA 71303-3538
Phone (318) 487-2020

Other identifiers 2

IdentifierTypeStateIssuer
1441210MedicaidLA
DC4592OtherLATRAVELERS MEDICARE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100930010267 LA DME Supplier - Physician - Optometrist 4789641010 Practice locations: Leesville, LA

Other NPIs with the same Medicare PAC ID 5

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Laboratory certificates & supplier records

Derived by NPIMap

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

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Alexandria Eye & Laser Center1008 S 6TH St, Leesville, LA 71446-4920(318) 487-2020 Prosthetic Lenses: Conventional Eyeglasses|Prosthetic Lenses: Conventional Contact Lenses|Prosthetic Lenses: Prosthetics Cataract Lenses Accepts assignmentParticipating since Jan 1, 2005

National Provider Directory

National Provider Directory
Tax ID family
Alexandria Eye Laser Cente17 organizations share this tax ID, including this one

Other organizations with this tax ID 16

Organizations that report the same tax identification number in the National Provider Directory.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1204070400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1736467200000",
    "number": "1447429022",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "231 WINDERMERE BLVD",
            "city": "ALEXANDRIA",
            "state": "LA",
            "postal_code": "713033538",
            "telephone_number": "318-487-2020",
            "fax_number": "318-445-7745"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1008 S 6TH ST",
            "city": "LEESVILLE",
            "state": "LA",
            "postal_code": "714464920",
            "telephone_number": "337-392-1994",
            "fax_number": "337-392-1944"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALEXANDRIA EYE AND LASER CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-27",
        "last_updated": "2025-01-10",
        "certification_date": "2025-01-10",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "OCTAVIA",
        "authorized_official_middle_name": "JACKSON",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "318-561-0946"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1441210",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRAVELERS MEDICARE",
            "identifier": "DC4592",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Leesville, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2025; 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.