Individual provider Active NPI

Dewanna K Staup, O.D.

  • Optometrist
  • Owens Cross Roads, AL
National Provider Identifier
1962439588
Registry record updated May 19, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
S-782-TA-246 Issued in AL
Practice address
6838 Highway 431 S
Suite a
Owens Cross Roads, AL 35763-7200
Phone
(256) 534-3900
NPI assigned
Jun 27, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 19, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X S-782-TA-246 AL Primary

Addresses

Primary practice location

6838 Highway 431 S
Suite a
Owens Cross Roads, AL 35763-7200

Mailing address

6838 Highway 431 S Ste a
Owens Cross Roads, AL 35763-7201
Phone (256) 534-3900

Other identifiers 1

IdentifierTypeStateIssuer
000058516MedicaidAL

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20080206000616 AL Practitioner - Optometry 7719060219 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of Alabama School of Medicine, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
South East EyecareGroup PAC ID 8729161229, 2 clinicians

Practice addresses (Care Compare)

6838 Hwy 431 S
Suite a
Owens Cross Roads, AL 35763-7201
Phone (256) 534-3900

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
S-782-TA-246ALMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
South East Eyecare Optometrist CurrentSince Jun 16, 1997 Accepting new patients

Locations

6838 Highway 431 S
Ste A
Owens X Rds, AL 35763
Phone (256) 534-3900

Organizations & group practices 1

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": "1151366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779148800000",
    "number": "1962439588",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6838 HIGHWAY 431 S STE A",
            "city": "OWENS CROSS ROADS",
            "state": "AL",
            "postal_code": "357637201",
            "telephone_number": "256-534-3900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6838 HIGHWAY 431 S",
            "address_2": "SUITE A",
            "city": "OWENS CROSS ROADS",
            "state": "AL",
            "postal_code": "357637200",
            "telephone_number": "256-534-3900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STAUP",
        "first_name": "DEWANNA",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-27",
        "last_updated": "2026-05-19",
        "certification_date": "2026-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AL",
            "license": "S-782-TA-246",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000058516",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Owens Cross Roads, AL

Sources for this page

Verify at the official NPI Registry.