NPIMap

Individual provider Active NPI

John B Carmody

  • Ophthalmology Physician
  • Shreveport, LA
National Provider Identifier
1619187648
Registry record updated Oct 14, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
201034 Issued in LA
Practice address
1801 Fairfield Ave
Suite 103
Shreveport, LA 71101-4443
Phone
(318) 841-3937
Fax
(318) 841-2505
NPI assigned
May 22, 2007
Last updated
Oct 14, 2009By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 201034 LA Primary

Addresses

Primary practice location

1801 Fairfield Ave
Suite 103
Shreveport, LA 71101-4443

Mailing address

PO Box 1062
Shreveport, LA 71163-1062
Phone (318) 841-3937

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091103000487 LA Practitioner - OphthalmologyPractitioner - Other (Physician) 2668547969 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Louisiana State University School of Medicine in Shreveport, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Shreveport Eye Clinic a Medical CorpGroup PAC ID 9830151117, 3 clinicians

Practice addresses (Care Compare)

1541 Kings Hwy
Shreveport, LA 71103-4228
Phone (318) 675-5000

471 Ashley Ridge Blvd
Suite 300
Shreveport, LA 71106-7229
Phone (318) 861-4009

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery226

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
201034LAMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lsu Health Sciences Center Shreveport Faculty Group Practice Ophthalmology CurrentSince Dec 1, 2016 Accepting new patients
Shreveport Eye Clinic a Medical Corp Ophthalmology CurrentSince Jul 15, 2019 Accepting new patients
Cherise a Irby, MD PastSince Oct 1, 2009 Accepting new patients

Locations

1420 Kings Hwy
Shreveport, LA 71103
Phone (318) 626-0717

1501 Kings Hwy
Shreveport, LA 71103
Phone (318) 626-0434

1512 W Kirby Pl
Shreveport, LA 71103
Phone (318) 626-0177

1541 Kings Hwy
Shreveport, LA 71103
Phone (318) 626-0287

1606 Kings Hwy
Shreveport, LA 71103
Phone (318) 675-6402

471 Ashley Ridge Blvd
Shreveport, LA 71106
Phone (318) 795-4770

471 Ashley Ridge Blvd
#300
Shreveport, LA 71106
Phone (318) 221-8646

471 Ashley Ridge Blvd
Ste 300
Shreveport, LA 71106

Interoperability endpoints

  • Direct secure messaging: john.carmody@spec.trimed.direct-ci.com

Organizations & group practices 4

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.

Hospital & facility affiliations 24

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1179792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1255478400000",
    "number": "1619187648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1062",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711631062",
            "telephone_number": "318-841-3937",
            "fax_number": "318-841-2505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 FAIRFIELD AVE",
            "address_2": "SUITE 103",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711014443",
            "telephone_number": "318-841-3937",
            "fax_number": "318-841-2505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARMODY",
        "first_name": "JOHN",
        "middle_name": "B",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-22",
        "last_updated": "2009-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "LA",
            "license": "201034",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shreveport, LA

Sources for this page

Verify at the official NPI Registry.