Active NPI
Rivertown Optical LLC
- Optician
- Slidell, LA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optician
- Legal business name
- RIVERTOWN OPTICAL LLC
- Practice address
- 401 Pontchartrain Drive Ste a
Slidell, LA 70458 - Phone
- (985) 641-1195
- Fax
- (985) 641-1193
- NPI assigned
- Jul 14, 2023
- Last updated
- Jul 14, 2023
- Organization subpart
- Yes
- Parent organization
- RIVERTOWN OPTICAL LLC
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Ms. Marion Pollet Favre
- Title
- Owner
- Phone
- (985) 641-1195
Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optician | 156FX1800X | Primary |
Addresses
Primary practice location
401 Pontchartrain Drive Ste a
Slidell, LA 70458
Mailing address
401 Pontchartrain Drive Ste a
Slidell, LA 70458
Phone (985) 641-1195
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1541176 | Medicaid | LA |
National Provider Directory
National Provider Directory- Tax ID family
- Rivertown Optical LLC
- Part of
- Rivertown Optical LLC
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Optician
- Slidell, LA
- NPI 1699455949
Practitioners & affiliated clinicians
Practitioners 2
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.
-
- Optician
- Slidell, LA
- NPI 1093855009
-
- Optometrist
- Slidell, LA
- NPI 1477517803
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1689292800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1689292800000",
"number": "1750060034",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "401 PONTCHARTRAIN DRIVE STE A",
"city": "SLIDELL",
"state": "LA",
"postal_code": "70458",
"telephone_number": "985-641-1195",
"fax_number": "985-641-1193"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "401 PONTCHARTRAIN DRIVE STE A",
"city": "SLIDELL",
"state": "LA",
"postal_code": "70458",
"telephone_number": "985-641-1195",
"fax_number": "985-641-1193"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "RIVERTOWN OPTICAL LLC",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "RIVERTOWN OPTICAL LLC",
"enumeration_date": "2023-07-14",
"last_updated": "2023-07-14",
"certification_date": "2023-07-14",
"status": "A",
"authorized_official_last_name": "FAVRE",
"authorized_official_first_name": "MARION",
"authorized_official_middle_name": "POLLET",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "985-641-1195",
"authorized_official_name_prefix": "Ms."
},
"taxonomies": [
{
"code": "156FX1800X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Technician/Technologist, Optician",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1541176",
"state": "LA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Slidell, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.