Individual provider Active NPI

Dannette Newman King, OD

  • Optometrist
  • Lucedale, MS
National Provider Identifier
1891810396
Registry record updated May 19, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
691 Issued in MS
Practice address
11228 Hwy 63 S
Lucedale, MS 39452
Phone
(601) 766-3800
Fax
(601) 947-2709
NPI assigned
Mar 21, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 19, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 691 MS Primary

Addresses

Primary practice location

11228 Hwy 63 S
Lucedale, MS 39452

Mailing address

3805 Cabildo PL
Ocean Springs, MS 39564-8551
Phone (228) 875-0673

Other identifiers 1

IdentifierTypeStateIssuer
C03344OtherGROUP

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
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
I20050726000344 MS Practitioner - Optometry 8123055886 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Premier Eye Clinic , PLLCGroup PAC ID 8224068010, 3 clinicians

Practice addresses (Care Compare)

4505 A Hospital St
Pascagoula, MS 39581-5302

4505 Hospital St
Suite a
Pascagoula, MS 39581-5302
Phone (228) 762-1525

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Eye Clinic, PLLC Optometrist CurrentSince Jan 20, 2020 Accepting new patients
Premier Eye Clinic , PLLC Optometrist CurrentSince Jan 20, 2020 Accepting new patients
King Eye Associates Inc Optometrist PastSince Jul 26, 2002 Accepting new patients

Locations

4505 Hospital St
Ste A
Pascagoula, MS 39581
Phone (228) 696-9707

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": "1174435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1400457600000",
    "number": "1891810396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3805 CABILDO PL",
            "city": "OCEAN SPRINGS",
            "state": "MS",
            "postal_code": "395648551",
            "telephone_number": "228-875-0673"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11228 HWY 63 S",
            "city": "LUCEDALE",
            "state": "MS",
            "postal_code": "39452",
            "telephone_number": "601-766-3800",
            "fax_number": "601-947-2709"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KING",
        "first_name": "DANNETTE",
        "middle_name": "NEWMAN",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-21",
        "last_updated": "2014-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MS",
            "license": "691",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP",
            "identifier": "C03344",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lucedale, MS

Sources for this page

Verify at the official NPI Registry.