Individual provider Active NPI

Lynne Sanders Stevens, O.D.

  • Optometrist
  • Birmingham, AL
National Provider Identifier
1477715399
Registry record updated Aug 8, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
S-B94-TA-803 Issued in AL
Practice address
833 Saint Vincents Dr
Suite 401
Birmingham, AL 35205-1606
Phone
(205) 933-7932
NPI assigned
Jul 1, 2008
Last updated
Aug 8, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X S-B94-TA-803 AL Primary

Addresses

Primary practice location

833 Saint Vincents Dr
Suite 401
Birmingham, AL 35205-1606

Mailing address

4053 White Oak Dr
Vestavia, AL 35243-5029
Phone (205) 382-1041

Other identifiers 4

IdentifierTypeStateIssuer
P00841079OtherRAILROAD MEDICARE
08028715OtherMSMEDICAID OF MISSISSIPPI
110054MedicaidAL
51598019OtherALBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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
I20090626000399 AL Practitioner - Optometry 0143371450 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
S-B94-TA-803ALMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
University of Alabama at Birmingham Current Accepting new patients
University of Alabama at Birmingham CurrentSince Jul 1, 2009 Accepting new patients
University of Alabama at Birmingham CurrentSince Jul 1, 2009 Accepting new patients

Locations

619 19th St S
Birmingham, AL 35233
Phone (205) 934-6405

Organizations & group practices 3

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": "1214870400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1470614400000",
    "number": "1477715399",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4053 WHITE OAK DR",
            "city": "VESTAVIA",
            "state": "AL",
            "postal_code": "352435029",
            "telephone_number": "205-382-1041"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "833 SAINT VINCENTS DR",
            "address_2": "SUITE 401",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352051606",
            "telephone_number": "205-933-7932"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEVENS",
        "first_name": "LYNNE",
        "middle_name": "SANDERS",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-01",
        "last_updated": "2016-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AL",
            "license": "S-B94-TA-803",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00841079",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID OF MISSISSIPPI",
            "identifier": "08028715",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110054",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "51598019",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Birmingham, AL

Sources for this page

Verify at the official NPI Registry.