Individual provider Active NPI

Laura Leanne Whitaker, O.D.

  • Optometrist
  • Athens, AL
National Provider Identifier
1710967609
Registry record updated Mar 14, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
S889TA445 Issued in AL
Practice address
22894 US Highway 72
Athens, AL 35613
Phone
(256) 232-2409
Fax
(256) 232-2402
NPI assigned
Jan 18, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X S889TA445 AL Primary

Addresses

Primary practice location

22894 US Highway 72
Athens, AL 35613

Mailing address

22894 US Highway 72
Athens, AL 35613
Phone (256) 232-2409

Other practice location 1

22984 US Highway 72
Athens, AL 35613
Phone (256) 232-2409

Other identifiers 3

IdentifierTypeStateIssuer
4835600001OtherALDME
51514732MedicaidAL
51514732OtherALBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100901000092 AL Practitioner - Optometry 2264538651 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University Alabama Birmingham - School of Optometry, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

22894 US Hwy 72
Athens, AL 35613-7671
Phone (256) 232-2409

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery60

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
S889TA445ALMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Athens Eye Care Center, P.C. Optometrist CurrentSince May 1, 2003 Accepting new patients
Maynor & Mitchell Eye Center PC Past Accepting new patients

Locations

22894 US Highway 72
Athens, AL 35613
Phone (256) 232-2409

309 W Market St
Athens, AL 35611
Phone (256) 232-2409

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1137542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552521600000",
    "number": "1710967609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22894 US HIGHWAY 72",
            "city": "ATHENS",
            "state": "AL",
            "postal_code": "35613",
            "telephone_number": "256-232-2409",
            "fax_number": "256-232-2402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22894 US HIGHWAY 72",
            "city": "ATHENS",
            "state": "AL",
            "postal_code": "35613",
            "telephone_number": "256-232-2409",
            "fax_number": "256-232-2402"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "22984 US HIGHWAY 72",
            "address_purpose": "LOCATION",
            "city": "Athens",
            "state": "AL",
            "postal_code": "35613",
            "country_code": "US",
            "telephone_number": "256-232-2409",
            "fax_number": "256-232-2402",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WHITAKER",
        "first_name": "LAURA",
        "middle_name": "LEANNE",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-18",
        "last_updated": "2019-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AL",
            "license": "S889TA445",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DME",
            "identifier": "4835600001",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "51514732",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "51514732",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Athens, AL

Sources for this page

Verify at the official NPI Registry.