NPIMap

Organization Active NPI

Southern Eye Institute LLC

  • Ophthalmology Physician
  • Houma, LA
National Provider Identifier
1912980566
Registry record updated Feb 8, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
022479 Issued in LA
Legal business name
SOUTHERN EYE INSTITUTE LLC
Practice address
446 Corporate Dr
Houma, LA 70360
Phone
(985) 872-5577
Fax
(985) 868-4190
NPI assigned
Nov 28, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2008

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

Authorized official

Name
Andrea J Kiefer
Title
Office Manager
Phone
(985) 872-5577

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193200000X MULTI-SPECIALTY GROUP 152W00000X 1412-554T LA
Ophthalmology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207W00000X 022479 LA Primary
Ophthalmology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207W00000X 011081 LA

Addresses

Primary practice location

446 Corporate Dr
Houma, LA 70360

Mailing address

446 Corporate Dr
Houma, LA 70360
Phone (985) 872-5577

Other identifiers 1

IdentifierTypeStateIssuer
1799718MedicaidLA

Other names 1

  • The Kellum Eye Center Doing business as

National Provider Directory

National Provider Directory

Locations

446 Corporate Dr
Houma, LA 70360
Phone (985) 448-3353

8120 Main St
Ste 402
Houma, LA 70360
Phone (985) 872-5577

NPI Registry JSON

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

{
    "created_epoch": "1133136000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1202428800000",
    "number": "1912980566",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "446 CORPORATE DR",
            "city": "HOUMA",
            "state": "LA",
            "postal_code": "70360",
            "telephone_number": "985-872-5577",
            "fax_number": "985-868-4190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "446 CORPORATE DR",
            "city": "HOUMA",
            "state": "LA",
            "postal_code": "70360",
            "telephone_number": "985-872-5577",
            "fax_number": "985-868-4190"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN EYE INSTITUTE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-28",
        "last_updated": "2008-02-08",
        "status": "A",
        "authorized_official_last_name": "KIEFER",
        "authorized_official_first_name": "ANDREA",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "985-872-5577"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "LA",
            "license": "1412-554T",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Ophthalmology",
            "state": "LA",
            "license": "022479",
            "primary": true
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Ophthalmology",
            "state": "LA",
            "license": "011081",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1799718",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Kellum Eye Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Houma, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 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.