Mitchell Eye Care Associates, L.L.C.

Primary specialty

OptometristTaxonomy code 152W00000X

License

1411-553T Issued in LA

Legal business name

MITCHELL EYE CARE ASSOCIATES, L.L.C.

Practice address

425 Saint Mary St
Thibodaux, LA 70301-2641

Phone

(985) 447-2393

Fax

(985) 447-2399

NPI assigned

May 18, 2006

Organization subpart

No

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

Authorized official

Name

Dr. David Mitchell, O.D.NPI 1912908658

Title

Manager

Phone

(985) 447-2393

Specialties & licenses 7

Addresses

Other identifiers 1

Other names 1

• Mitchell Family Eye Care Doing business as

Medicare fee-for-service enrollment

Enrolled in LA

Enrollment records 1

Locations

Practitioners 4

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

• David Mitchell, O.D.

  • Optometrist
  • Thibodaux, LA
  • NPI 1912908658
  Medicare reassignment Care Compare group NPD Authorized official
• Jenaye Marie Deroche, OD

  • Optometrist
  • Thibodaux, LA
  • NPI 1427536937
  Medicare reassignment Care Compare group NPD
• Lisa L Mitchell, OD

  • Optometrist
  • Thibodaux, LA
  • NPI 1427059146
  Medicare reassignment Care Compare group NPD
• Gabriel Kevin Kasovich, OD

  • Optometrist
  • Metairie, LA
  • NPI 1407959406
  Medicare reassignment NPD

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

{
    "created_epoch": "1147910400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1480636800000",
    "number": "1568415776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "425 SAINT MARY ST",
            "city": "THIBODAUX",
            "state": "LA",
            "postal_code": "703012641",
            "telephone_number": "985-447-2393",
            "fax_number": "985-447-2399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 SAINT MARY ST",
            "city": "THIBODAUX",
            "state": "LA",
            "postal_code": "703012641",
            "telephone_number": "985-447-2393",
            "fax_number": "985-447-2399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MITCHELL EYE CARE ASSOCIATES, L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-18",
        "last_updated": "2016-12-02",
        "status": "A",
        "authorized_official_last_name": "MITCHELL",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "985-447-2393",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "LA",
            "license": "1411-553T",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "LA",
            "license": "1412-554T",
            "primary": false
        },
        {
            "code": "152WC0802X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "LA",
            "license": "1411-553T",
            "primary": false
        },
        {
            "code": "152WP0200X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist, Pediatrics",
            "state": "LA",
            "license": "1412-554T",
            "primary": false
        },
        {
            "code": "152WS0006X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist, Sports Vision",
            "state": "LA",
            "license": "1411-553T",
            "primary": false
        },
        {
            "code": "152WV0400X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist, Vision Therapy",
            "state": "LA",
            "license": "1411-553T",
            "primary": false
        },
        {
            "code": "152WX0102X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist, Occupational Vision",
            "state": "LA",
            "license": "1412-554T",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1507032",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mitchell Family Eye Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Whitney Miller
• Millers Care Coordination & Behavioral Health, LLC
• Mindful Matters Counseling Services
• Brittany Trosclair Mire, APRN,FNP-C, PMHNP-BC
• Mary Elaine Mire, RPH
• David Mitchell, O.D.
• Lisa L Mitchell, OD
• James Kevin Modisette, M.D.
• Joshua Moffett, LPC
• George Molaison, LPC, M.A.

• Optometrist in Thibodaux, LA
• Providers in Thibodaux, LA by specialty
• Optometrist in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2016; 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.