Active NPI
Angela Dowdy Prince, OD
- Optometrist
- Jasper, AL
National Provider Identifier
1801908546
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- S841TA374
- Practice address
- 1801 Highway 78 E
Jasper, AL 35501-4037 - Phone
- (205) 302-0020
- Fax
- (205) 387-3426
- NPI assigned
- Aug 31, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | S841TA374 | AL | Primary |
Addresses
Primary practice location
1801 Highway 78 E
Jasper, AL 35501-4037
Mailing address
540 Mount View Rd
Hayden, AL 35079-8618
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 51525032 | Other | AL | BLUE CROSS AND BLUE SHIEL |
| 1637815 | Other | LA | MEDICAID |
| 926295 | Other | AL | BLOCK VISION |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20050120000978 | AL | Practitioner - Optometry | 5193774776 | Practice locations: Jasper, AL |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| S841TA374 | AL | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156982400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1801908546",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "540 MOUNT VIEW RD",
"city": "HAYDEN",
"state": "AL",
"postal_code": "350798618"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1801 HIGHWAY 78 E",
"city": "JASPER",
"state": "AL",
"postal_code": "355014037",
"telephone_number": "205-302-0020",
"fax_number": "205-387-3426"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PRINCE",
"first_name": "ANGELA",
"middle_name": "DOWDY",
"name_prefix": "Dr.",
"credential": "OD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-08-31",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "AL",
"license": "S841TA374",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS AND BLUE SHIEL",
"identifier": "51525032",
"state": "AL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAID",
"identifier": "1637815",
"state": "LA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLOCK VISION",
"identifier": "926295",
"state": "AL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Jasper, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.