Individual provider Active NPI

Carla S Courtney, O.D.

  • Optometrist
  • Durant, IA
National Provider Identifier
1801845581
Registry record updated Oct 9, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2013 Issued in IA
Practice address
409 8TH Ave
Durant, IA 52747
Phone
(563) 785-4497
Fax
(563) 785-4607
NPI assigned
May 9, 2006
Sex
Female
Sole proprietor
Yes

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.

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Eye Care Pavilion PLC 4 clinicians

Practice addresses (Care Compare)

4310 E 53Rd St
Davenport, IA 52807-3039
Phone (563) 324-2020

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
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.

Medicare enrollment records 1

Medicare enrollment files
Enrollment IDStateProvider typePAC IDDetails
I20050707000768 IA Practitioner - Optometry 3072559376 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2013IAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Eye Care Pavilion PLC Optometrist CurrentSince Feb 20, 2015 Accepting new patients
Anderson & Brown Eye Care, PLC Optometrist Past Accepting new patients

Locations

4310 E 53rd St
Davenport, IA 52807
Phone (563) 322-1158

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2013 IA Primary

Addresses

NPPES NPI Registry

Primary practice location

409 8TH Ave
Durant, IA 52747

Mailing address

PO Box 37
Durant, IA 52747-0037
Phone (563) 785-4497

Other identifiers 1

NPPES NPI Registry
IdentifierTypeStateIssuer
1286781MedicaidIA

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Oct 9, 2013.

{
    "created_epoch": "1147132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1381276800000",
    "number": "1801845581",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 37",
            "city": "DURANT",
            "state": "IA",
            "postal_code": "527470037",
            "telephone_number": "563-785-4497",
            "fax_number": "563-785-4607"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "409 8TH AVE",
            "city": "DURANT",
            "state": "IA",
            "postal_code": "52747",
            "telephone_number": "563-785-4497",
            "fax_number": "563-785-4607"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COURTNEY",
        "first_name": "CARLA",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-05-09",
        "last_updated": "2013-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IA",
            "license": "2013",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1286781",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Durant, IA

Sources for this page

Verify at the official NPI Registry.