Shreveport Eye Specialists, LLC

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

MD.024870 Issued in LA

Legal business name

SHREVEPORT EYE SPECIALISTS, LLC

Practice address

1801 Fairfield Ave Ste 207
Shreveport, LA 71101-4460

Phone

(318) 489-5949

NPI assigned

Sep 12, 2017

Organization subpart

No

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

Authorized official

Name

Dr. Russell H Van Norman, MDNPI 1679576961

Title

Owner

Phone

(318) 703-5655

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in LA

Enrollment records 1

Locations

Practitioners 2

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

• Russell H Vannorman III, M.D.

  • Cornea and External Diseases Specialist Physician
  • Shreveport, LA
  • NPI 1679576961

  LA, Ophthalmology

  Medicare reassignment Care Compare group NPD Authorized official
• Rachel Catherine Meyer-Borel

  • Optometrist
  • Shreveport, LA
  • NPI 1790194751

  LA

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1505174400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1516838400000",
    "number": "1528587441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1801 FAIRFIELD AVE STE 207",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711014460",
            "telephone_number": "318-703-5655",
            "fax_number": "318-606-5470"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 FAIRFIELD AVE STE 207",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711014460",
            "telephone_number": "318-489-5949"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHREVEPORT EYE SPECIALISTS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-09-12",
        "last_updated": "2018-01-25",
        "status": "A",
        "authorized_official_last_name": "VAN NORMAN",
        "authorized_official_first_name": "RUSSELL",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "318-703-5655",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "LA",
            "license": "MD.024870",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shreveport Doctors Hospital 2003, LTD.
• Shreveport Doctors' Hospital
• Shreveport Doctors' Hospital
• Shreveport Endoscopy Center, a Medical Corporation
• Shreveport Eye Clinic a Medical Corp
• Shreveport Family Medicine Inc
• Shreveport Geriatrics
• Shreveport Geriatrics
• Shreveport Health and Wellness
• Shreveport Internal Medicine and Pediatrics LLC

• All providers in Shreveport, LA
• Ophthalmology Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2018; 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.