Organization Active NPI

Alicia P Crooks, a Professional Optometry LLC

  • Optometrist
  • Bossier City, LA
National Provider Identifier
1679979694
Registry record updated Nov 19, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1558-590T Issued in LA
Legal business name
ALICIA P CROOKS, A PROFESSIONAL OPTOMETRY LLC
Practice address
2536 Airline Dr
Bossier City, LA 71111-5813
Phone
(318) 623-1664
NPI assigned
Nov 19, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2014

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

Authorized official

Name
Dr. Alicia K Crooks, OD
Title
Optometrist
Phone
(318) 623-1664

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 1558-590T LA Primary

Addresses

Primary practice location

2536 Airline Dr
Bossier City, LA 71111-5813

Mailing address

134 Dogwood South LN
Haughton, LA 71037-7512
Phone (318) 623-1664

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150427002164 LA Part B Supplier - Clinic/Group Practice 3173842093 Receives reassigned benefits from 1 practitioner
Practice locations: Bossier City, LA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1416355200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1416355200000",
    "number": "1679979694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "134 DOGWOOD SOUTH LN",
            "city": "HAUGHTON",
            "state": "LA",
            "postal_code": "710377512",
            "telephone_number": "318-623-1664"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2536 AIRLINE DR",
            "city": "BOSSIER CITY",
            "state": "LA",
            "postal_code": "711115813",
            "telephone_number": "318-623-1664"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALICIA P CROOKS, A PROFESSIONAL OPTOMETRY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-11-19",
        "last_updated": "2014-11-19",
        "status": "A",
        "authorized_official_last_name": "CROOKS",
        "authorized_official_first_name": "ALICIA",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "318-623-1664",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "LA",
            "license": "1558-590T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bossier City, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2014; 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.