Organization Active NPI

Lagniappe Eye Care Inc.

  • Optometrist
  • Hattiesburg, MS
National Provider Identifier
1447511571
Registry record updated Apr 13, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
689 Issued in MS
Legal business name
LAGNIAPPE EYE CARE INC.
Practice address
6152 U S Highway 98
Suite 30
Hattiesburg, MS 39402-4200
Phone
(601) 336-8062
NPI assigned
Jun 5, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2015

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

Authorized official

Name
Deborah Marcev, ODNPI 1154365542
Title
President
Phone
(601) 329-1796

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
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 689 MS Primary

Addresses

Primary practice location

6152 U S Highway 98
Suite 30
Hattiesburg, MS 39402-4200

Mailing address

6152 U S Highway 98
Suite 30
Hattiesburg, MS 39402-4200
Phone (601) 336-8062

Other identifiers 1

IdentifierTypeStateIssuer
00880226MedicaidMS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120713000442 MS Part B Supplier - Clinic/Group Practice 9638334808 Receives reassigned benefits from 2 practitioners
Practice locations: Hattiesburg, MS

National Provider Directory

National Provider Directory

Locations

6169 U S Highway 98
Hattiesburg, MS 39402
Phone (601) 335-8368

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1338854400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1428883200000",
    "number": "1447511571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6152 U S HIGHWAY 98",
            "address_2": "SUITE 30",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394024200",
            "telephone_number": "601-336-8062"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6152 U S HIGHWAY 98",
            "address_2": "SUITE 30",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394024200",
            "telephone_number": "601-336-8062"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAGNIAPPE EYE CARE INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-06-05",
        "last_updated": "2015-04-13",
        "status": "A",
        "authorized_official_last_name": "MARCEV",
        "authorized_official_first_name": "DEBORAH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "601-329-1796",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "MS",
            "license": "689",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00880226",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hattiesburg, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.