NPIMap

Organization Active NPI

Eyewear Boutique Inc

Doing business as Randall V Christian

  • Eyewear Supplier
  • Opelousas, LA
National Provider Identifier
1477722460
Registry record updated Apr 18, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Eyewear SupplierTaxonomy code 332H00000X
License
793-005T Issued in LA
Legal business name
EYEWEAR BOUTIQUE INC
Doing business as
Randall V Christian
Practice address
232 N Union St
Opelousas, LA 70570-6208
Phone
(337) 948-9504
Fax
(337) 942-3545
NPI assigned
Feb 25, 2008
Last updated
Apr 18, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2013

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

Authorized official

Name
Karen S Christian
Title
Vice President
Phone
(337) 948-9504

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Eyewear Supplier 332H00000X 793-005T LA Primary

Addresses

Primary practice location

232 N Union St
Opelousas, LA 70570-6208

Mailing address

232 N Union St
Opelousas, LA 70570-6208
Phone (337) 948-9504

Other identifiers 1

IdentifierTypeStateIssuer
1178322MedicaidLA

Other names 1

  • Randall V Christian Doing business as

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20100930025018 LA DME Supplier - Physician - Optometrist 6204969470 Practice locations: Opelousas, LA
O20240724004100 LA Part B Supplier - Clinic/Group Practice 6204969470 Receives reassigned benefits from 1 practitioner
Practice locations: Opelousas, LA

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

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
Eyewear Boutique Inc232 N Union St, Opelousas, LA 70570-6208(337) 948-9504 Prosthetic Lenses: Conventional Eyeglasses|Prosthetic Lenses: Conventional Contact Lenses Accepts assignmentParticipating since May 26, 2010

National Provider Directory

National Provider Directory
Tax ID family
Eyewear Boutique Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

232 N Union St
Opelousas, LA 70570
Phone (337) 948-9504

Practitioners & affiliated clinicians

Practitioners 1

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": "1203897600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1366243200000",
    "number": "1477722460",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "232 N UNION ST",
            "city": "OPELOUSAS",
            "state": "LA",
            "postal_code": "705706208",
            "telephone_number": "337-948-9504",
            "fax_number": "337-942-3545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "232 N UNION ST",
            "city": "OPELOUSAS",
            "state": "LA",
            "postal_code": "705706208",
            "telephone_number": "337-948-9504",
            "fax_number": "337-942-3545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYEWEAR BOUTIQUE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-25",
        "last_updated": "2013-04-18",
        "status": "A",
        "authorized_official_last_name": "CHRISTIAN",
        "authorized_official_first_name": "KAREN",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "337-948-9504"
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "LA",
            "license": "793-005T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1178322",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Randall V Christian",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Opelousas, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2013; 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.