Individual provider Active NPI

Deana McGowan Clifton, O.D.

  • Optometrist
  • Bossier City, LA
National Provider Identifier
1952404352
Registry record updated Jan 16, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1426-561T Issued in LA
Practice address
1000 Chinaberry Dr
Suite 302
Bossier City, LA 71111-2442
Phone
(318) 550-5815
Fax
(318) 550-5686
NPI assigned
Sep 7, 2006
Last updated
Jan 16, 2012By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 16, 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 1426-561T LA Primary

Addresses

Primary practice location

1000 Chinaberry Dr
Suite 302
Bossier City, LA 71111-2442

Mailing address

1000 Chinaberry Dr
Suite 302
Bossier City, LA 71111-2442
Phone (318) 550-5815

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
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
I20101027001557 LA Practitioner - Optometry 2567656192 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1000 Chinaberry Dr
Suite 302
Bossier City, LA 71111-2443
Phone (318) 550-5815

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1426-561TLAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Deana M Clifton a Professional Optometry Corporation Optometrist CurrentSince Oct 1, 2011 Accepting new patients
Charles E Lyon, MD, Apmc Optometrist PastSince Jul 1, 1999 Accepting new patients

Locations

1000 Chinaberry Dr
Ste 302
Bossier City, LA 71111
Phone (318) 550-5815

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1157587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1326672000000",
    "number": "1952404352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 CHINABERRY DR",
            "address_2": "SUITE 302",
            "city": "BOSSIER CITY",
            "state": "LA",
            "postal_code": "711112442",
            "telephone_number": "318-550-5815",
            "fax_number": "318-550-5686"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 CHINABERRY DR",
            "address_2": "SUITE 302",
            "city": "BOSSIER CITY",
            "state": "LA",
            "postal_code": "711112442",
            "telephone_number": "318-550-5815",
            "fax_number": "318-550-5686"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLIFTON",
        "first_name": "DEANA",
        "middle_name": "MCGOWAN",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-07",
        "last_updated": "2012-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "LA",
            "license": "1426-561T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bossier City, LA

Sources for this page

Verify at the official NPI Registry.