NPIMap

Organization Active NPI

Gandy Eye Care a Professional

  • Optometrist
  • Rayville, LA
National Provider Identifier
1447458286
Registry record updated Jan 6, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 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
Last updated
Jan 6, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2011

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

Authorized official

Name
Dr. Stacy G Gandy, O.D.NPI 1205831252
Title
Doctor
Phone
(318) 728-2299

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
Optometrist 152W00000X LA Primary

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 2

IdentifierTypeStateIssuer
1945811MedicaidLA
2455BOtherLABLUECROSSBLUESHIELD OF LA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
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

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
Gandy Eye Care107 Maxwell Dr, Rayville, LA 71269-5558(318) 728-2299 Prosthetic Lenses: Conventional Eyeglasses|Prosthetic Lenses: Conventional Contact Lenses Accepts assignmentParticipating since Jan 1, 2017

National Provider Directory

National Provider Directory

Locations

404 S Washington St
Bastrop, LA 71220
Phone (318) 281-6682

311 Lake St
Lake Providence, LA 71254

107 Maxwell Dr
Rayville, LA 71269
Phone (318) 728-2277

Practitioners & affiliated clinicians

Practitioners 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1183420800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1294272000000",
    "number": "1447458286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 MAXWELL DR",
            "city": "RAYVILLE",
            "state": "LA",
            "postal_code": "712695558",
            "telephone_number": "318-728-2299",
            "fax_number": "318-728-0081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 MAXWELL DR",
            "city": "RAYVILLE",
            "state": "LA",
            "postal_code": "712695558",
            "telephone_number": "318-728-2299",
            "fax_number": "318-728-0081"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GANDY EYE CARE A PROFESSIONAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-03",
        "last_updated": "2011-01-06",
        "status": "A",
        "authorized_official_last_name": "GANDY",
        "authorized_official_first_name": "STACY",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "318-728-2299",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "LA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1945811",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSSBLUESHIELD OF LA",
            "identifier": "2455B",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rayville, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2011; 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.