Eddie Dale McClure, OPTICIAN

Primary specialty

OpticianTaxonomy code 156FX1800X

License

10-00013656 Issued in LA

Practice address

5368 Kennesaw Dr
Baton Rouge, LA 70817-2555

Phone

(225) 753-0441

Fax

(225) 753-3320

NPI assigned

Sep 8, 2011

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Glasses Unlimited, Inc.

  • Eyewear Supplier
  • Bossier City, LA
  • NPI 1508876095
  NPD (past) Authorized official

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

{
    "created_epoch": "1315440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1315440000000",
    "number": "1750662474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3153 E TEXAS ST",
            "city": "BOSSIER CITY",
            "state": "LA",
            "postal_code": "711113209",
            "telephone_number": "225-753-0441",
            "fax_number": "225-753-3320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5368 KENNESAW DR",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708172555",
            "telephone_number": "225-753-0441",
            "fax_number": "225-753-3320"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCLURE",
        "first_name": "EDDIE",
        "middle_name": "DALE",
        "credential": "OPTICIAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-09-08",
        "last_updated": "2011-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Optician",
            "state": "LA",
            "license": "10-00013656",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID NPI NUMBER",
            "identifier": "1508876095",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1156612",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Scott C McClelland, P.T.
• Alicia Nicole McClinton, LCSW
• Calvin H McClinton, MASTER OF SCIENCE
• Adam Ripley McClure, MD
• Alyssa Michele McClure
• Jacie J McClure, DPT
• Kaley McClure, CRNA
• Lindsey McClure
• Stephanie McClure
• Megan McCollum, PT

• Optician in Baton Rouge, LA
• Providers in Baton Rouge, LA by specialty
• Optician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2011; 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.