Individual provider Active NPI

Clifton M. Cowan, O.D.

  • Corneal and Contact Management Optometrist
  • Leesville, LA
National Provider Identifier
1811980600
Registry record updated Oct 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Corneal and Contact Management OptometristTaxonomy code 152WC0802X
License
953-128T Issued in LA
Practice address
1100 N. 5TH St.
Leesville, LA 71446-3464
Phone
(337) 239-2020
Fax
(337) 239-0755
NPI assigned
Aug 26, 2005
Last updated
Oct 20, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Corneal and Contact Management Optometrist 152WC0802X 953-128T LA Primary

Addresses

Primary practice location

1100 N. 5TH St.
Leesville, LA 71446-3464

Mailing address

PO Box 681
Leesville, LA 71496-0681
Phone (337) 239-2020

Other identifiers 1

IdentifierTypeStateIssuer
1342262MedicaidLA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
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
I20100626000354 LA Practitioner - Optometry 7719018365 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of Houston - College of Optometry, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Thomas Vision Clinic, IncGroup PAC ID 0042341950, 2 clinicians

Practice addresses (Care Compare)

1100 N 5TH St
Leesville, LA 71446-2910
Phone (337) 239-2020

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery46

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Thomas Vision Clinic, Inc Corneal and Contact Management CurrentSince Feb 16, 2010 Accepting new patients

Locations

1100 N 5th St
Leesville, LA 71446
Phone (318) 239-2020

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1125014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1224460800000",
    "number": "1811980600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 681",
            "city": "LEESVILLE",
            "state": "LA",
            "postal_code": "714960681",
            "telephone_number": "337-239-2020",
            "fax_number": "337-239-0755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 N. 5TH ST.",
            "city": "LEESVILLE",
            "state": "LA",
            "postal_code": "714463464",
            "telephone_number": "337-239-2020",
            "fax_number": "337-239-0755"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COWAN",
        "first_name": "CLIFTON",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-26",
        "last_updated": "2008-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "LA",
            "license": "953-128T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1342262",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Leesville, LA

Sources for this page

Verify at the official NPI Registry.