SUDARSAN CHAVALA (NPI# 1891906848) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1891906848 |
| Entity Type | Organization |
| Organization Name | SUDARSAN CHAVALA |
| Other Organization Name | MARYVILLE EYE CLINIC |
| Practice Address |
1303 N 25th Bethany MO 64424 |
| Mailing Address |
2024 S Main St Maryville MO 64468-2655 |
| Practice Telephone | 6604252317 |
| Practice Fax Number | 6604252317 |
| Mailing Telephone | 6605622566 |
| Mailing Fax Number | 6605622432 |
| Enumeration Date | 2007-05-24 |
| Last Update Date | 2008-06-30 |
| Authorized Official Name | DR. SUDARSAN CHAVALA (PHYSICIAN) |
| Authorized Official Telephone | 6604252317 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | Y |
| Parent Organization Name | MARYVILLE EYE CLINIC |
| Parent Organization TIN |
|
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207W00000X | Ophthalmology | R8855 | MO | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | 201965209 | 05 |
| Other Name | Type Code |
|---|---|
| maryville eye clinic | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639292527 | Sudarsan Chavala | Eyewear Supplier (Equipment, not the service) | 2024 S Main St, Maryville, MO 64468-2655 | 2007-04-07 |
| 1023229549 | Sudarsan Chavala | Ophthalmology | 102 E Adams St, Suite 2, Mount Ayr, IA 50854-1621 | 2007-05-25 |
| Street Address |
1303 N 25TH |
| City | BETHANY |
| State | MO |
| Zip Code | 64424 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376739946 | Cynthia Sue Butler | Social Worker | 4118 Miller St, Bethany, MO 64424 | 2007-09-18 |
| 1972521300 | Gary Ernest Anderson | Chiropractor | 3307 Miller, Bethany, MO 64424 | 2006-07-17 |
| 1558397661 | N & R of Crestview LLC | Skilled Nursing Facility | 1313 South 25th Street, Bethany, MO 64424 | 2006-06-23 |
| 1639147507 | Jayne E. Doolittle | Nurse Practitioner | 2703 Miller St., Bethany, MO 64424 | 2006-03-08 |
| 1205436946 | Douglas Faulkner | Pharmacist | 810 S 37th St, Bethany, MO 64424 | 2020-10-30 |
| 1184088593 | Patricia Slaughter | Social Worker | 2600 Miller St, Bethany, MO 64424 | 2016-04-12 |
| 1912235706 | Bethany Counseling Center LLC | Social Worker | 4118 Miller St, Bethany, MO 64424 | 2009-12-07 |
| 1568430437 | Gregory A Dean | Family Medicine | 2703 Miller St, Bethany, MO 64424 | 2006-03-08 |
| 1508834409 | Terry E. Hall | General Practice | 2703 Miller St., Bethany, MO 64424-0233 | 2006-03-08 |
| 1730251646 | Harrison County Health Department & Harrison County Home Health | Home Health | 1700 Bethany Avenue, Bethany, MO 64424-0425 | 2006-11-15 |
| Find all providers in zip 64424 | ||||
| Taxonomy Code | 207W00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Ophthalmology |
| An ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Ophthalmology, 2007. http://www.abop.org/. American Osteopathic Board of Ophthalmology and Otolaryngology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Ophthalmology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780299578 | Heart of America Eye Care Pa | Ophthalmology | 1147 E North Ave, Belton, MO 64012-5105 | 2020-09-09 |
| 1962020644 | Matthew Theodore Hirabayashi | Ophthalmology | University Hospital One Hospital Dr Dc052.00, Columbia, MO 65212-0001 | 2020-07-09 |
| 1508484288 | Travis Parker | Ophthalmology | University Hospital One Hospital Drive Dc 052.00, Columbia, MO 65212-0001 | 2020-07-09 |
| 1003466897 | Mcelhinney Eye Care, Pa | Ophthalmology | 1004 Carondelet Dr Ste 405, Kansas City, MO 64114-4801 | 2019-09-13 |
| 1952965493 | Eric Jiaming Zhang | Ophthalmology | University Hospital One Hospital Dr Dc.052.00, Columbia, MO 65212-0001 | 2019-04-30 |
| 1790265759 | Washington University | Ophthalmology | 4901 Forest Park Ave # 8221, Saint Louis, MO 63108-1495 | 2018-08-20 |
| 1023597127 | Eye Care Pa | Ophthalmology | 1018 W Foxwood Drive, Raymore, MO 64083 | 2018-08-09 |
| 1255716221 | Summit Eye Center, LLC | Ophthalmology | 1621 Nw Blue Parkway, Lees Summit, MO 64086 | 2015-07-20 |
| 1184038986 | Grace L Paley | Ophthalmology | 621 S New Ballas Rd Ste 5006b, Saint Louis, MO 63141-8270 | 2014-06-19 |
| 1871907378 | Daniel Joseph Watson | Ophthalmology | 900 N Highway 67 St, Florissant, MO 63031 | 2014-06-12 |
| Find all providers with the same taxonomy | ||||
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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.