Individual provider Active NPI

Peggy H Gramates, MD

  • Ophthalmology Physician
  • Pineville, LA
National Provider Identifier
1831123181
Registry record updated Sep 1, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
036-097318 Issued in IL
Practice address
2495 Shreveport Hwy
Pineville, LA 71360-4044
Phone
(318) 473-0010
NPI assigned
Jul 11, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 1, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 036-097318 IL Primary

Addresses

Primary practice location

2495 Shreveport Hwy
Pineville, LA 71360-4044

Mailing address

2495 Shreveport Hwy
Pineville, LA 71360-4044

Other identifiers 2

IdentifierTypeStateIssuer
289730001OtherILPTAN
1831123181OtherILNPI NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036-097318ILMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Rapides Healthcare System, LLC Current Accepting new patients
Rapides Healthcare System, LLC CurrentSince Oct 19, 2015 Accepting new patients
Rapides Healthcare System LLC CurrentSince Oct 19, 2015 Accepting new patients
Robert J S Mack, MD PC Ophthalmology PastSince Nov 7, 2016 Accepting new patients
Koziol-Thoms Eye Associates S.C. Ophthalmology Past Accepting new patients
The Eye Site of Illinois, LLC Past Accepting new patients
Deborah R. Distefano M.D.P.C. Past Accepting new patients
Koziol-Thoms Eye Associates S.C. Ophthalmology PastSince Mar 15, 1990 Accepting new patients

Locations

211 4th St
Alexandria, LA 71301
Phone (318) 473-3000

301 4th St
Ste 3
Alexandria, LA 71301

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1152576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1472688000000",
    "number": "1831123181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2495 SHREVEPORT HWY",
            "city": "PINEVILLE",
            "state": "LA",
            "postal_code": "713604044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2495 SHREVEPORT HWY",
            "city": "PINEVILLE",
            "state": "LA",
            "postal_code": "713604044",
            "telephone_number": "318-473-0010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAMATES",
        "first_name": "PEGGY",
        "middle_name": "H",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-11",
        "last_updated": "2016-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "IL",
            "license": "036-097318",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "289730001",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI NUMBER",
            "identifier": "1831123181",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pineville, LA

Sources for this page

Verify at the official NPI Registry.