Individual provider Active NPI

Laura R. Evans, O.D.

  • Optometrist
  • Cape Girardeau, MO
National Provider Identifier
1831263375
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
T03451 Issued in MO
Practice address
3230 Blattner Dr.
Cape Girardeau, MO 63703-6380
Phone
(573) 334-2020
Fax
(573) 334-2915
NPI assigned
Nov 17, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X T03451 MO Primary

Addresses

Primary practice location

3230 Blattner Dr.
Cape Girardeau, MO 63703-6380

Mailing address

3230 Blattner Dr.
Cape Girardeau, MO 63703-6380
Phone (573) 334-2020

Other identifiers 1

IdentifierTypeStateIssuer
314852815MedicaidMO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20101007000094 MO Practitioner - Optometry 0840392890 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Saint Louis University School of Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gregory S. Leet, O.D., P.C.Group PAC ID 5496857443, 8 clinicians

Practice addresses (Care Compare)

1014 E Jackson Blvd
Jackson, MO 63755-2436
Phone (573) 243-2020

707 N Main St
Leet Eye Care
Perryville, MO 63775-1303
Phone (573) 547-1898

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery36

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Gregory S. Leet, O.D., P.C. Optometrist CurrentSince Nov 1, 2002 Accepting new patients
Tennessee Vision Partners PLLC Optometrist Past Accepting new patients
Nto Denton, PLLC Optometrist Past Accepting new patients

Locations

3230 Blattner Dr
Cape Girardeau, MO 63703
Phone (573) 334-2020

3140 Blattner Dr
Cpe Girardeau, MO 63703
Phone (573) 334-2020

2110 E Jackson Blvd
Jackson, MO 63755
Phone (314) 334-2020

1014 E Jackson Blvd
Jackson, MO 63755
Phone (573) 243-2020

Organizations & group practices 3

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": "1163721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1831263375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3230 BLATTNER DR.",
            "city": "CAPE GIRARDEAU",
            "state": "MO",
            "postal_code": "637036380",
            "telephone_number": "573-334-2020",
            "fax_number": "573-334-2915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3230 BLATTNER DR.",
            "city": "CAPE GIRARDEAU",
            "state": "MO",
            "postal_code": "637036380",
            "telephone_number": "573-334-2020",
            "fax_number": "573-334-2915"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVANS",
        "first_name": "LAURA",
        "middle_name": "R.",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MO",
            "license": "T03451",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "314852815",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cape Girardeau, MO

Sources for this page

Verify at the official NPI Registry.