Individual provider Active NPI

Elizabeth Martin Granger, O.D.

  • Optometrist
  • Zachary, LA
National Provider Identifier
1730158841
Registry record updated Jan 13, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
975-141T Issued in LA
Practice address
5233 Main St
Suite a
Zachary, LA 70791-3978
Phone
(225) 654-0090
Fax
(225) 654-8044
NPI assigned
Mar 14, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 975-141T LA Primary

Addresses

Primary practice location

5233 Main St
Suite a
Zachary, LA 70791-3978

Mailing address

5233 Main St
Suite a
Zachary, LA 70791-3978
Phone (225) 654-0090

Other identifiers 1

IdentifierTypeStateIssuer
1358908MedicaidLA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
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
I20090420000333 LA Practitioner - Optometry 0749337251 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Williamson Eye CenterGroup PAC ID 9335131192, 19 clinicians

Practice addresses (Care Compare)

5233 Main St
Suite a
Zachary, LA 70791-3978
Phone (225) 654-0090

550 Connell Park LN
Baton Rouge, LA 70806-6539
Phone (225) 924-2020

550 Connells Park Lane
Baton Rouge, LA 70806-6539

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
975-141TLAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Williamson Eye Center Optometrist Current Accepting new patients
Williamson Eye Center Optometrist CurrentSince Jan 15, 2009 Accepting new patients
Williamson Eye Center Optometrist Current Accepting new patients
Williamson Eye Center Optometrist CurrentSince Jan 15, 2009 Accepting new patients
Williamson Eye Center Optometrist Past Accepting new patients
Jonathan M. Levy, DPM, PC Past Accepting new patients

Locations

9001 Summa Ave
Ste 245
Baton Rouge, LA 70809
Phone (225) 490-5299

550 Connell Park Ln
Baton Rouge, LA 70806
Phone (225) 924-2020

9001 Summa Ave
Baton Rouge, LA 70809

2290 S Range Ave
Denham Springs, LA 70726
Phone (225) 665-2019

2308 S Burnside Ave
Gonzales, LA 70737
Phone (225) 644-7525

230 Roberts Dr
Ste J
New Roads, LA 70760
Phone (225) 618-0088

5233 Main St
Ste A
Zachary, LA 70791
Phone (225) 654-0090

Organizations & group practices 6

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": "1142294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1231804800000",
    "number": "1730158841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5233 MAIN ST",
            "address_2": "SUITE A",
            "city": "ZACHARY",
            "state": "LA",
            "postal_code": "707913978",
            "telephone_number": "225-654-0090",
            "fax_number": "225-654-8044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5233 MAIN ST",
            "address_2": "SUITE A",
            "city": "ZACHARY",
            "state": "LA",
            "postal_code": "707913978",
            "telephone_number": "225-654-0090",
            "fax_number": "225-654-8044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRANGER",
        "first_name": "ELIZABETH",
        "middle_name": "MARTIN",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-14",
        "last_updated": "2009-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "LA",
            "license": "975-141T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1358908",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Zachary, LA

Sources for this page

Verify at the official NPI Registry.