Individual provider Active NPI

Devin Coleman

  • Optometrist
  • Laurie, MO
National Provider Identifier
1457159790
Registry record updated May 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2025018601 Issued in MO
Practice address
130 S Main St
Laurie, MO 65038
Phone
(573) 374-5222
NPI assigned
Mar 4, 2025
Last updated
May 29, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 29, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2025018601 MO Primary

Addresses

Primary practice location

130 S Main St
Laurie, MO 65038

Mailing address

6619 243Rd CT
Salem, WI 53168-8803
Phone (262) 308-3561

Other practice location 1

117 South Business Route Hwy 5
Camdenton, MO 65020
Phone (573) 346-5951

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20251002001579 MO Practitioner - Optometry 7315443918 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Paige Hedgpath OdpcGroup PAC ID 5991856460, 25 clinicians

Practice addresses (Care Compare)

3251 Bagnell Dam Blvd
Suite D
Lake Ozark, MO 65049-9728
Phone (573) 365-3717

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2025018601MOMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Paige Hedgpath Odpc Optometrist CurrentSince Aug 17, 2025 Accepting new patients
Paige Hedgpath OD,PC Optometrist CurrentSince Aug 17, 2025 Accepting new patients
B &B Eyecare, LLC Optometrist Past Accepting new patients
Lake Ozark Family Eyecare, Inc. Optometrist Past Accepting new patients

Locations

117 S Business Route 5
Camdenton, MO 65020
Phone (573) 346-5951

1400 Forum Blvd
Ste 14
Columbia, MO 65203
Phone (573) 446-0331

138 S Main St
Gravois Mills, MO 65037
Phone (573) 280-2884

323 Monroe St
Jefferson Cty, MO 65101
Phone (573) 635-1313

3251 Bagnell Dam Blvd
Ste D
Lake Ozark, MO 65049
Phone (573) 365-3717

5962 Osage Beach Pkwy
Osage Beach, MO 65065
Phone (573) 348-2747

6756 Chippewa St
Saint Louis, MO 63109
Phone (314) 351-4991

Organizations & group practices 4

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": "1741046400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748476800000",
    "number": "1457159790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6619 243RD CT",
            "city": "SALEM",
            "state": "WI",
            "postal_code": "531688803",
            "telephone_number": "262-308-3561"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 S MAIN ST",
            "city": "LAURIE",
            "state": "MO",
            "postal_code": "65038",
            "telephone_number": "573-374-5222"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "117 South Business Route Hwy 5",
            "address_purpose": "LOCATION",
            "city": "Camdenton",
            "state": "MO",
            "postal_code": "65020",
            "country_code": "US",
            "telephone_number": "573-346-5951",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COLEMAN",
        "first_name": "DEVIN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-03-04",
        "last_updated": "2025-05-29",
        "certification_date": "2025-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MO",
            "license": "2025018601",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Laurie, MO

Sources for this page

Verify at the official NPI Registry.