Organization Active NPI

Milliken Eye Care, LLC

  • Optometrist
  • Vidalia, LA
National Provider Identifier
1952651523
Registry record updated May 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
792 Issued in MS
Legal business name
MILLIKEN EYE CARE, LLC
Doing business as
Miss Lou Eye Care
Practice address
202 Advocate Row
Vidalia, LA 71373-3000
Phone
(601) 443-9876
Fax
(601) 442-4000
NPI assigned
Sep 11, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 28, 2024

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

Authorized official

Name
Mrs. Nancy Anders
Title
Manager
Phone
(601) 443-9876

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 792 MS Primary

Addresses

Primary practice location

202 Advocate Row
Vidalia, LA 71373-3000

Mailing address

202 Advocate Row
Vidalia, LA 71373-3000
Phone (601) 443-9876

Other identifiers 2

IdentifierTypeStateIssuer
005352884MedicaidMS
09825097MedicaidMS

Other names 1

  • Miss Lou Eye Care Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS, LA3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20121218000025 MS Part B Supplier - Clinic/Group Practice 8022260132 Receives reassigned benefits from 1 practitioner
Practice locations: Natchez, MS
O20130228000277 MS DME Supplier - Physician - OptometristDME Supplier - Optician 8022260132 Practice locations: Vidalia, LA
O20221021000716 LA Part B Supplier - Clinic/Group Practice 8022260132 Receives reassigned benefits from 1 practitioner
Practice locations: Vidalia, LA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
25D2083284Miss-Lou Eye Care202 Advocate Row, Vidalia, LA 71373Certificate of waiverSep 1, 2026

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Milliken Eye Care LLC202 Advocate Row, Vidalia, LA 71373-3000(601) 443-9876 Prosthetic Lenses: Conventional Eyeglasses|Prosthetic Lenses: Conventional Contact Lenses Accepts assignmentParticipating since Dec 28, 2012

National Provider Directory

National Provider Directory

Locations

202 Advocate Row
Vidalia, LA 71373
Phone (601) 443-9876

Interoperability endpoints

  • Direct secure messaging: bmilliken@millikenec.eyefinity-direct.com

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1347321600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1716854400000",
    "number": "1952651523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "202 ADVOCATE ROW",
            "city": "VIDALIA",
            "state": "LA",
            "postal_code": "713733000",
            "telephone_number": "601-443-9876",
            "fax_number": "601-442-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "202 ADVOCATE ROW",
            "city": "VIDALIA",
            "state": "LA",
            "postal_code": "713733000",
            "telephone_number": "601-443-9876",
            "fax_number": "601-442-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MILLIKEN EYE CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-09-11",
        "last_updated": "2024-05-28",
        "certification_date": "2024-05-28",
        "status": "A",
        "authorized_official_last_name": "ANDERS",
        "authorized_official_first_name": "NANCY",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "601-443-9876",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "MS",
            "license": "792",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "005352884",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "09825097",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Miss Lou Eye Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Vidalia, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.