Stanford Vision Clinic LLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

STANFORD VISION CLINIC LLC

Practice address

306 N Commerce St
Ripley, MS 38663-1721

Phone

(662) 837-7822

NPI assigned

Dec 11, 2018

Organization subpart

No

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

Authorized official

Name

Dr. Megan Roebuck Stanford, ODNPI 1972951663

Title

Optometrist/Owner

Phone

(901) 647-0988

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MS

Enrollment records 1

Practitioners 2

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

• Megan Roebuck Stanford, O.D.

  • Optometrist
  • San Antonio, TX
  • NPI 1972951663

  MS

  Medicare reassignment NPD Authorized official
• John David Stanford, DDS

  • Dentist
  • Ripley, MS
  • NPI 1952313132
  NPD (past)

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

{
    "created_epoch": "1544486400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1544486400000",
    "number": "1679044044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "306 N COMMERCE ST",
            "city": "RIPLEY",
            "state": "MS",
            "postal_code": "386631721",
            "telephone_number": "662-837-7822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "306 N COMMERCE ST",
            "city": "RIPLEY",
            "state": "MS",
            "postal_code": "386631721",
            "telephone_number": "662-837-7822"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STANFORD VISION CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-12-11",
        "last_updated": "2018-12-11",
        "status": "A",
        "authorized_official_last_name": "STANFORD",
        "authorized_official_first_name": "MEGAN",
        "authorized_official_middle_name": "ROEBUCK",
        "authorized_official_title_or_position": "OPTOMETRIST/OWNER",
        "authorized_official_telephone_number": "901-647-0988",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• South Tippah School District
• Dwalia Sherree South-Bitter, MD
• Diana Baker Spencer, R.PH.
• Rebecca Marie Ragland Spencer
• Stanford Dental Clinic, LLC
• John David Stanford, DDS
• Cheryl D Stevenson
• Lauren Bailey Steverson, PT
• Wanda Sue Stroupe, NP
• Anna Katherine Tanner, MSW

• Clinic/Center in Ripley, MS
• Providers in Ripley, MS by specialty
• Clinic/Center in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2018; 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.