Boreing Vision Clinic Inc

Primary specialty

Vision Therapy OptometristTaxonomy code 152WV0400X

License

904-130T Issued in LA

Legal business name

BOREING VISION CLINIC INC

Practice address

500 W McNeese St
Lake Charles, LA 70605-5528

Phone

(337) 474-6161

Fax

(337) 474-6474

NPI assigned

Mar 15, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Jennifer Smith, OPTOMETRISTNPI 1255983557

Title

Owner

Phone

(337) 474-6161

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in LA

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jennifer Stewart Smith, OD

  • Optometrist
  • Lake Charles, LA
  • NPI 1255983557
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1173916800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1647302400000",
    "number": "1770617342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 W MCNEESE ST",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706055528",
            "telephone_number": "337-474-6161",
            "fax_number": "337-474-6474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 W MCNEESE ST",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706055528",
            "telephone_number": "337-474-6161",
            "fax_number": "337-474-6474"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOREING VISION CLINIC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-15",
        "last_updated": "2022-03-15",
        "certification_date": "2022-03-14",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "337-474-6161",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OPTOMETRIST"
    },
    "taxonomies": [
        {
            "code": "152WV0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist, Vision Therapy",
            "state": "LA",
            "license": "904-130T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "4318819170",
            "identifier": "BLUECROSS BLUESHIELD",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mellisa Lau Booth
• Charlotte Martia Bordelon
• Deborah Bordelon, LPC
• Barry Stephen Bordenave, M.D.
• Bruce P. Bordlee, M.D.
• Howard Bosely
• Juan Manual Bossano, MD
• Alisha Boudreaux
• Caitlyn Boudreaux, APRN
• Candice Alea Boudreaux

• Vision Therapy Optometrist in Lake Charles, LA
• Providers in Lake Charles, LA by specialty
• Vision Therapy Optometrist in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.