Southside Eye Care PLLC

Primary specialty

OptometristTaxonomy code 152W00000X

License

0618000583 Issued in VA

Legal business name

SOUTHSIDE EYE CARE PLLC

Practice address

3206 Churchland Blvd
Chesapeake, VA 23321-5206

Phone

(757) 484-0101

Fax

(757) 484-0515

NPI assigned

Oct 18, 2005

Organization subpart

No

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

Authorized official

Name

Dr. Michael R Keverline, MDNPI 1962401612

Title

Owner

Phone

(757) 484-0101

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in VA2 enrollments

Enrollment records 2

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

CLIA laboratory certificates

Locations

Interoperability endpoints

• Direct secure messaging: mkeverline@southsideeye.intellechartdirect.net
• Direct secure messaging: thallberg@southsideeye.intellechartdirect.net
• Direct secure messaging: iuber@southsideeye.intellechartdirect.net

Practitioners 3

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

• Michael Raymond Keverline, MD

  • Ophthalmology Physician
  • Chesapeake, VA
  • NPI 1962401612
  Medicare reassignment Care Compare group NPD Authorized official
• Theodore M Hallberg, OD

  • Optometrist
  • Chesapeake, VA
  • NPI 1255331757
  Medicare reassignment Care Compare group NPD
• Ian Chauncey Uber, M.D.

  • Ophthalmology Physician
  • Portsmouth, VA
  • NPI 1891016796
  Medicare reassignment NPD

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

{
    "created_epoch": "1129593600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1434326400000",
    "number": "1992794325",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3206 CHURCHLAND BLVD",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233215206",
            "telephone_number": "757-484-0101",
            "fax_number": "757-484-0515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3206 CHURCHLAND BLVD",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233215206",
            "telephone_number": "757-484-0101",
            "fax_number": "757-484-0515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHSIDE EYE CARE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-18",
        "last_updated": "2015-06-15",
        "status": "A",
        "authorized_official_last_name": "KEVERLINE",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "757-484-0101",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "VA",
            "license": "0618000583",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89015TY",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Southeastern Virginia Training Center
• Southeastern Virginia Training Center
• Southeastern Virginia Training Center
• Southern Medical Transport Service Inc
• Southpeake Enterprises, Inc.
• Southside Services, LLC
• Sova Home Health LLC
• Adama Sow
• Elana M Sowers, LCSW
• Naquarion Xavier Spain

• Optometrist in Chesapeake, VA
• Providers in Chesapeake, VA by specialty
• Optometrist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2015; 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.