Desoto Family Vision PLLC

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

DESOTO FAMILY VISION PLLC

Practice address

1228 Goodman Rd E Ste 1
Southaven, MS 38671-9540

Phone

(662) 893-3300

NPI assigned

Nov 16, 2023

Last updated

Nov 16, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. David Parker, ODNPI 1558321729

Title

Owner

Phone

(662) 893-3300

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MS

Enrollment records 1

Locations

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• David Lloyd Parker, O.D.

  • Optometrist
  • Olive Branch, MS
  • NPI 1558321729
  Medicare reassignment NPD Authorized official
• Sean Phillip Aldinger, OD

  • Optometrist
  • Olive Branch, MS
  • NPI 1659330231
  Medicare reassignment NPD
• Walter Pang, O.D.

  • Optometrist
  • Clinton, MS
  • NPI 1548692130
  Medicare reassignment NPD
• Aaron Tyler Renfrow, OD

  • Optometrist
  • Hernando, MS
  • NPI 1467132290
  Medicare reassignment NPD
• Louis Magee III

  • Optometrist
  • Southaven, MS
  • NPI 1316866262
  NPD (past)
• Alan Charles Smith, O.D.

  • Optometrist
  • Southaven, MS
  • NPI 1235213687
  NPD (past)

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

{
    "created_epoch": "1700092800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1700092800000",
    "number": "1679348924",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6947 CRUMPLER BLVD",
            "city": "OLIVE BRANCH",
            "state": "MS",
            "postal_code": "386541922",
            "telephone_number": "662-893-3300",
            "fax_number": "662-893-3301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1228 GOODMAN RD E STE 1",
            "city": "SOUTHAVEN",
            "state": "MS",
            "postal_code": "386719540",
            "telephone_number": "662-893-3300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DESOTO FAMILY VISION PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-11-16",
        "last_updated": "2023-11-16",
        "certification_date": "2023-11-16",
        "status": "A",
        "authorized_official_last_name": "PARKER",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "662-893-3300",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Desoto Eyecare Inc
• Desoto Family Care Clinic, PLLC
• Desoto Family Counseling Center PLLC
• Desoto Family Counseling Center, PLLC
• Desoto Family Medical Center
• Desoto Family Wellness Center, LLC
• Desoto Familycounseling Center
• Desoto Healthcare Inc (Desoto Healthcare Center)
• Desoto Heart Clinic, PC
• Desoto Osteopathic

• Optometrist in Southaven, MS
• Providers in Southaven, MS by specialty
• Optometrist in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2023; 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.