Active NPI
Deanna Van Stavoren, OD
- Optometrist
- Pikeville, KY
National Provider Identifier
1619894300
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 2494DT
- Practice address
- 147 Sycamore St
Pikeville, KY 41501-9118 - Phone
- (606) 218-5511
- NPI assigned
- Jul 2, 2026
- Last updated
- Jul 15, 2026
- 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 | 2494DT | KY | Primary |
Addresses
Primary practice location
147 Sycamore St
Pikeville, KY 41501-9118
Mailing address
1619 War Fork Rd
Vansant, VA 24656-8524
Phone (276) 312-0729
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1782950400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1784073600000",
"number": "1619894300",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1619 WAR FORK RD",
"city": "VANSANT",
"state": "VA",
"postal_code": "246568524",
"telephone_number": "276-312-0729"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "147 SYCAMORE ST",
"city": "PIKEVILLE",
"state": "KY",
"postal_code": "415019118",
"telephone_number": "606-218-5511"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VAN STAVOREN",
"first_name": "DEANNA",
"credential": "OD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2026-07-02",
"last_updated": "2026-07-15",
"certification_date": "2026-07-15",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "KY",
"license": "2494DT",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Pikeville, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.