Randy Stephen Coshatt, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

S-375-TA-023 Issued in AL

Practice address

112 5TH St NE
Aliceville, AL 35442-2200

Phone

(205) 373-6374

Fax

(205) 373-6163

NPI assigned

Jun 9, 2005

Sex

Male

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 4

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1118275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1259020800000",
    "number": "1932103652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 5TH ST NE",
            "city": "ALICEVILLE",
            "state": "AL",
            "postal_code": "354422200",
            "telephone_number": "205-373-6374",
            "fax_number": "205-373-6163"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 5TH ST NE",
            "city": "ALICEVILLE",
            "state": "AL",
            "postal_code": "354422200",
            "telephone_number": "205-373-6374",
            "fax_number": "205-373-6163"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COSHATT",
        "first_name": "RANDY",
        "middle_name": "STEPHEN",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-09",
        "last_updated": "2009-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AL",
            "license": "S-375-TA-023",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA GOVERNMENT SERVICES",
            "identifier": "0275270001",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "51059452",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000059452",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DMEPOS",
            "identifier": "0275270001",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Optometrist in Aliceville, AL
• Providers in Aliceville, AL by specialty
• Optometrist in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.