Active NPI
Diana Hughes Dean
- Optometrist
- Columbia, MO
National Provider Identifier
1548212129
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 2006010743
- Practice address
- 1205 Grindstone Pkwy
Suite 113
Columbia, MO 65201 - Phone
- (573) 442-5725
- Fax
- (573) 442-5747
- NPI assigned
- May 16, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 2006010743 | MO | Primary |
Addresses
Primary practice location
1205 Grindstone Pkwy
Suite 113
Columbia, MO 65201
Mailing address
1205 Grindstone Pkwy
Suite 113
Columbia, MO 65201-3755
Phone (573) 442-5725
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2006010743 | Other | MO | MO |
| 18003368 | Other | UPIN PENDING |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2006010743 | MO | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Major Hospital | Past | Accepting new patients | |
| Dr Tavel of Evansville, LLC | Optometrist | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Optometrist
- Evansville, IN
- NPI 1205825700
-
- General Acute Care Hospital
- Shelbyville, IN
- NPI 1174555692
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147737600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1527206400000",
"number": "1548212129",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1205 GRINDSTONE PKWY",
"address_2": "SUITE 113",
"city": "COLUMBIA",
"state": "MO",
"postal_code": "652013755",
"telephone_number": "573-442-5725",
"fax_number": "573-442-5747"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1205 GRINDSTONE PKWY",
"address_2": "SUITE 113",
"city": "COLUMBIA",
"state": "MO",
"postal_code": "65201",
"telephone_number": "573-442-5725",
"fax_number": "573-442-5747"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HUGHES DEAN",
"first_name": "DIANA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-05-16",
"last_updated": "2018-05-25",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "MO",
"license": "2006010743",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MO",
"identifier": "2006010743",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UPIN PENDING",
"identifier": "18003368",
"state": null
}
],
"endpoints": [],
"other_names": []
}
Other providers in Columbia, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.