Kathe S Champagne, OPTICIAN

Primary specialty

OpticianTaxonomy code 156FX1800X

License

96872008 Issued in AL

Practice address

12999 6TH Street
Lillian, AL 36549-4107

Phone

(251) 962-3077

Fax

(251) 962-3083

NPI assigned

Mar 17, 2008

Last updated

Apr 17, 2008By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Champagne Optical

  • Optician
  • Lillian, AL
  • NPI 1396912945
  NPD (past) Authorized official

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

{
    "created_epoch": "1205712000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1208390400000",
    "number": "1881865061",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12999 6TH ST",
            "city": "LILLIAN",
            "state": "AL",
            "postal_code": "365494107",
            "telephone_number": "251-962-3077",
            "fax_number": "251-962-3083"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12999 6TH STREET",
            "city": "LILLIAN",
            "state": "AL",
            "postal_code": "365494107",
            "telephone_number": "251-962-3077",
            "fax_number": "251-962-3083"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAMPAGNE",
        "first_name": "KATHE",
        "middle_name": "S",
        "name_prefix": "Mrs.",
        "credential": "OPTICIAN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-03-17",
        "last_updated": "2008-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Optician",
            "state": "AL",
            "license": "96872008",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "0822990001",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Appalachian Medical Equipment Co., Inc. (Bayside Medical Equipment)
• Champagne Optical
• Donna Maria Chetta, RN, CHES, CHC
• Clover Care Transport, Inc
• David B. Keddy, M.D.
• Stacy Davis, RPH
• Encore Rehabilitation, Inc. (Encore Rehab of Lillian)

• Optician in Lillian, AL
• Providers in Lillian, AL by specialty
• Optician in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.