Individual provider Active NPI

Lee Roy Thompson, OD

  • Optometrist
  • Tuscaloosa, AL
National Provider Identifier
1871564203
Registry record updated Nov 26, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
T567-TA-343 Issued in AL
Practice address
3701 Loop Rd
Tuscaloosa Vamc
Tuscaloosa, AL 35404-5015
Phone
(205) 554-2822
NPI assigned
Feb 1, 2006
Last updated
Nov 26, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 26, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X T567-TA-343 AL Primary

Addresses

Primary practice location

3701 Loop Rd
Tuscaloosa Vamc
Tuscaloosa, AL 35404-5015

Mailing address

3701 Loop Rd
Tuscaloosa Vamc
Tuscaloosa, AL 35404-5015
Phone (205) 554-2822

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121205000286 AL Order and Referring Only - OptometryPractitioner - Optometry 2163674748

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
T567-TA-343ALMDOptometrist

NPI Registry JSON

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

{
    "created_epoch": "1138752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1353888000000",
    "number": "1871564203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3701 LOOP RD",
            "address_2": "TUSCALOOSA VAMC",
            "city": "TUSCALOOSA",
            "state": "AL",
            "postal_code": "354045015",
            "telephone_number": "205-554-2822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3701 LOOP RD",
            "address_2": "TUSCALOOSA VAMC",
            "city": "TUSCALOOSA",
            "state": "AL",
            "postal_code": "354045015",
            "telephone_number": "205-554-2822"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMPSON",
        "first_name": "LEE",
        "middle_name": "ROY",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-01",
        "last_updated": "2012-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AL",
            "license": "T567-TA-343",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tuscaloosa, AL

Sources for this page

Verify at the official NPI Registry.