Gandy Eye Care a Professional
Organization Active NPI Optometrist · Rayville, LA
NPI 1447458286 · NPPES record last updated Jan 6, 2011
Key facts
- NPI
- 1447458286
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Optometrist 152W00000X
- Legal business name
- GANDY EYE CARE A PROFESSIONAL
- Practice address
- 107 Maxwell Dr
Rayville, LA 71269-5558 - Phone
- (318) 728-2299
- Fax
- (318) 728-0081
- NPI assigned
- Jul 3, 2007
- Organization subpart
- No
Authorized official
- Name
- Dr. Stacy G Gandy, O.D.
- Title
- Doctor
- Phone
- (318) 728-2299
Practitioners 5
-
Jimmy S Gandy, O.D.
-
Stacy G Gandy, O.D.
-
Frances Louise Davis, O.D.
Laboratory certificates & supplier records
Medicare medical equipment & supply locations
| Supplier | Supplies | Medicare assignment |
|---|---|---|
| Gandy Eye Care |
Prosthetic Lenses: Conventional Eyeglasses|Prosthetic Lenses: Conventional Contact Lenses | Accepts assignment |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in LA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20071019000434 | LA | Part B Supplier - Clinic/Group Practice | 7719073857 |
Receives reassigned benefits from 5 practitioners Practice locations: Bastrop, LA; Rayville, LA; Winnsboro, LA |
| O20100930019875 | LA | DME Supplier - Physician - Optometrist | 7719073857 | Practice locations: Rayville, LA |
National Provider Directory
Locations
404 S Washington St
Bastrop, LA 71220
Phone (318) 281-6682
311 Lake St
Lake Providence, LA 71254
6609 Main St
Winnsboro, LA 71295
Phone (318) 435-5145
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist |
152W00000X | LA | Yes |
Addresses
Primary practice location
107 Maxwell Dr
Rayville, LA 71269-5558
Mailing address
107 Maxwell Dr
Rayville, LA 71269-5558
Phone (318) 728-2299
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2455B | Other | LA | BLUECROSSBLUESHIELD OF LA |
| 1945811 | Medicaid | LA |
Other providers in Rayville, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 6, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.