Keshia S. Elder, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

T193TA757 Issued in AL

Practice address

1716 University Blvd
HPB G080A
Birmingham, AL 35294-0010

Phone

(205) 975-2020

Fax

(205) 934-6755

NPI assigned

Apr 12, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 4

Other names 1

• Ms. Keishia S Sims Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• University Specialty Clinics - Ophthalmology

  • Ophthalmology Physician
  • Columbia, SC
  • NPI 1275561771
  NPD (past)

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

{
    "created_epoch": "1144800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1475452800000",
    "number": "1649234295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1716 UNIVERSITY BLVD",
            "address_2": "HPB G080A",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352940010",
            "telephone_number": "205-975-2020",
            "fax_number": "205-934-6755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1716 UNIVERSITY BLVD",
            "address_2": "HPB G080A",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352940010",
            "telephone_number": "205-975-2020",
            "fax_number": "205-934-6755"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELDER",
        "first_name": "KESHIA",
        "middle_name": "S.",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-12",
        "last_updated": "2016-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AL",
            "license": "T193TA757",
            "primary": true
        },
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "SC",
            "license": "1188",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MO",
            "license": "2011023817",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "D11887",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1649234295",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9912034",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF ALABAMA",
            "identifier": "51543068",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KEISHIA",
            "last_name": "SIMS",
            "middle_name": "S",
            "prefix": "MS.",
            "credential": "O.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Rizk M El-Galley, MD
• Rowan El-Qishawi
• Brooke Elam
• Mohamed Samir Hassan Elawady
• James Earnest Elder, M.D.
• Pamela Kay Elder, M.A., CCC
• Jennifer Phillips Eldredge, M.D.
• Kenna Riley Eldridge
• Paul Duncan Eleazer, DDS
• Electric Mobility Corporation

• Optometrist in Birmingham, AL
• Providers in Birmingham, AL by specialty
• Optometrist in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.