Individual provider Active NPI

Steve M Depriest, OD

  • Optometrist
  • Oxford, MS
National Provider Identifier
1801964259
Registry record updated Oct 28, 2008
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Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
500 Issued in MS
Practice address
611 Van Buren Ave
Oxford, MS 38655-3839
Phone
(662) 234-6033
NPI assigned
Dec 2, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 28, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 500 MS Primary

Addresses

Primary practice location

611 Van Buren Ave
Oxford, MS 38655-3839

Mailing address

P O Box 1097
Oxford, MS 38655-3839
Phone (662) 234-6033

Other identifiers 1

IdentifierTypeStateIssuer
00087923MedicaidMS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080911000310 MS Practitioner - Optometry 4880760008 Practice locations: Oxford, MS

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 1981
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

611 Van Buren Ave
Oxford, MS 38655-3839
Phone (662) 234-6033

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery12

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1165017600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1225152000000",
    "number": "1801964259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P O BOX 1097",
            "city": "OXFORD",
            "state": "MS",
            "postal_code": "386553839",
            "telephone_number": "662-234-6033",
            "fax_number": "662-234-6033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "611 VAN BUREN AVE",
            "city": "OXFORD",
            "state": "MS",
            "postal_code": "386553839",
            "telephone_number": "662-234-6033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEPRIEST",
        "first_name": "STEVE",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-02",
        "last_updated": "2008-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MS",
            "license": "500",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00087923",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oxford, MS

Sources for this page

Verify at the official NPI Registry.