Organization Active NPI

Stevenson Medical Surgical Eye Center

  • Ophthalmology Physician
  • Raceland, LA
National Provider Identifier
1699886325
Registry record updated Jul 21, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
02476R Issued in LA
Legal business name
STEVENSON MEDICAL SURGICAL EYE CENTER
Practice address
4777 Hwy 1 S
Raceland, LA 70394
Phone
(985) 537-7000
Fax
(985) 537-7001
NPI assigned
Aug 31, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2008

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

Authorized official

Name
Onex Dara Stevenson, MD
Title
Medical Director Physician
Phone
(985) 537-7000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207W00000X 02476R LA Primary

Addresses

Primary practice location

4777 Hwy 1 S
Raceland, LA 70394

Mailing address

4777 Hwy 1 South
Raceland, LA 70394
Phone (985) 537-7000

Other identifiers 1

IdentifierTypeStateIssuer
1798894MedicaidLA

National Provider Directory

National Provider Directory

Locations

4777 Highway 1
Raceland, LA 70394
Phone (985) 537-5512

Practitioners & affiliated clinicians

Practitioners 5

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": "1156982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1216598400000",
    "number": "1699886325",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4777 HWY 1 SOUTH",
            "city": "RACELAND",
            "state": "LA",
            "postal_code": "70394",
            "telephone_number": "985-537-7000",
            "fax_number": "985-537-7001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4777 HWY 1 S",
            "city": "RACELAND",
            "state": "LA",
            "postal_code": "70394",
            "telephone_number": "985-537-7000",
            "fax_number": "985-537-7001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STEVENSON MEDICAL SURGICAL EYE CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-31",
        "last_updated": "2008-07-21",
        "status": "A",
        "authorized_official_last_name": "STEVENSON",
        "authorized_official_first_name": "ONEX",
        "authorized_official_middle_name": "DARA",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR PHYSICIAN",
        "authorized_official_telephone_number": "985-537-7000",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "LA",
            "license": "02476R",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1798894",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Raceland, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2008; 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.