DR. LAURA MARIE SUPPA (NPI# 1235571563) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1235571563 |
| Entity Type | Individual |
| Full Name | DR. LAURA MARIE SUPPA |
| Credential | OD |
| Practice Address |
4202 Maccorkle Ave Se Charleston WV 25304-2502 |
| Practice Telephone | 3049254761 |
| Practice Fax Number | 3049250310 |
| Mailing Telephone | 3049254761 |
| Mailing Fax Number | 3049250310 |
| Enumeration Date | 2013-07-29 |
| Last Update Date | 2015-01-21 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 152W00000X | Optometrist | 2002-IOD1 | WV | Eye and Vision Services Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962744326 | Laura Suppa | Occupational Therapist | 536 Grand Slam Dr, Suite D, Evans, GA 30809-8044 | 2013-03-25 |
| Street Address |
4202 MACCORKLE AVE SE |
| City | CHARLESTON |
| State | WV |
| Zip Code | 25304-2502 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790885655 | William Alan Rada | Optometrist | 4202 Maccorkle Ave Se, Charleston, WV 25304-2502 | 2006-09-22 |
| 1841485687 | William Alan Rada, Od | Optometrist | 4202 Maccorkle Ave Se, Charleston, WV 25304-2502 | 2007-09-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740893908 | Sade Yvonne Rice | Technician | 392 B South Parkd Rd, Charleston, WV 25304 | 2020-08-27 |
| 1053931410 | Pir Ali Shah | Student in an Organized Health Care Education/Training Program | 3200 Maccorkle Avenue Southeast Robert C. Bind Clinical, Charleston, WV 25304 | 2020-04-25 |
| 1649807603 | Jasmine Shah | Student in an Organized Health Care Education/Training Program | 3110 Maccorkle Avenue, Se, Student Services Department - Wvu Building, 4th Floor, Charleston, WV 25304 | 2020-03-26 |
| 1447811872 | Kwasi Amponsah Gambrah | Student in an Organized Health Care Education/Training Program | 3200 Mac Corkle Ave. Se, Robert C. Byrd Clinical Teaching Center, 5th Floor, Charlestoni, WV 25304 | 2019-06-26 |
| 1457916751 | Divya Kalluru | Student in an Organized Health Care Education/Training Program | 3200 Maccorkle Avenue Southeast, Robert C. Bird Clinica, 4th Floor Internal Medicine Department, Charleston, WV 25304 | 2019-05-02 |
| 1841854965 | Sean Michael Percy Losier | Student in an Organized Health Care Education/Training Program | 3200 Maccorkle Ave., Se, Camc Family Medicine Center Robert C. Byrd Clinical Tea, Charleston, WV 25304 | 2019-04-24 |
| 1700440047 | Priyanka Chowdhry | Student in an Organized Health Care Education/Training Program | Robert C. Bird Clinical Training Center, 4th Floor, 3200 Maccorkle Avenue, Southeast, Charleston, WV 25304 | 2019-04-23 |
| 1568925469 | Saranya Dinesan | Student in an Organized Health Care Education/Training Program | 3200 Maccorkle Ave. Se, 4th Floor, Robert C. Byrd Clini, Charleston, WV 25304 | 2019-04-09 |
| 1043771694 | Mary Elizabeth Novak | Student in an Organized Health Care Education/Training Program | Camc Memorial Hospital, Surgicare Center, 3200 Maccorkle Ave Se, Charleston, WV 25304 | 2019-03-27 |
| 1124518600 | Abdullah Sohail | Student in an Organized Health Care Education/Training Program | 4th Floor, 3200 Maccorkle Ave, South East Robert C. Bir, Charleston, WV 25304 | 2018-05-10 |
| Find all providers in zip 25304 | ||||
| Taxonomy Code | 152W00000X |
| Grouping | Eye and Vision Services Providers |
| Classification | Optometrist |
| Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system. |
| Notes: Source: American Optometric Association (AOA), approved by the AOA’s Board of Trustees, June 21, 2005. [7/1/2006: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083248785 | National Vision Inc | Optometrist | 2031 Sam Rittenberg Blvd Ste 101, Charleston, SC 29407-4681 | 2020-03-03 |
| 1679046569 | Eye Care Associates of Sc | Optometrist | 8484 Dorchester Rd Ste B3, Charleston, SC 29420-7319 | 2019-01-03 |
| 1740612506 | Megan Marie Sexton | Optometrist | 1470 Tobias Gadson Blvd Ste 115, Charleston, SC 29407-4835 | 2013-08-05 |
| 1760722482 | Lowcountry Vision Care, LLC | Optometrist | 91 Broad St, Charleston, SC 29401-2272 | 2013-02-16 |
| 1922271774 | See Inc | Optometrist | 355 King St, Charleston, SC 29401-1438 | 2008-04-11 |
| 1841481769 | Steven James Hosman | Optometrist | 1301 Lee St East, Charleston, WV 25301 | 2007-08-06 |
| 1346442571 | Donald Paul Cohen | Optometrist | 924 Quarrier St, Charleston, WV 25301-2619 | 2007-06-01 |
| 1053537068 | Coastal Eye Care of Charleston, LLC | Optometrist | 1606 Harbor View Rd, Charleston, SC 29412-3216 | 2007-04-18 |
| 1760500524 | Coastal Eye Care of Daniel Island | Optometrist | 225 Seven Farms Drive, 105, Charleston, SC 29492 | 2007-03-27 |
| 1790809226 | Gregory S Moore Od PC | Optometrist | 2335 Chesterfield Ave Ste 303, Charleston, WV 25304-1066 | 2007-03-19 |
| Find all providers in CHARLESTON | ||||
| City | CHARLESTON |
| Zip Code | 25304 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.