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VISION SOURCE ALEXANDRIA LLC
NPI 1356694434
Optometrist in Alexandria, LA

Active since October 26, 2012
5615B JACKSON STREET EXT, ALEXANDRIA, LA 71303(318) 442-7787(318) 443-1654 Get Directions Write a Review

NPPES record last updated: October 26, 2012. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Vision Source Alexandria Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

VISION SOURCE ALEXANDRIA LLC (NPI 1356694434) is a healthcare organization registered as an optometrist in Alexandria, Louisiana and active in the NPI registry since October 2012. The organization lists Lacy B Shaw, Owner/doctor, as its authorized official.

NPPES Registry Identity

NPI1356694434
Entity TypeOrganization
Primary Taxonomy152W00000X
Legal Business NameVISION SOURCE ALEXANDRIA LLC
Location Address5615B JACKSON STREET EXTAlexandria, LA 71303-2275
Mailing Address5615b Jackson Street ExtAlexandria, LA 71303-2275 · (318) 442-7787 · Fax (318) 443-1654
Phone(318) 442-7787
Fax(318) 443-1654
Organization SubpartNo
Authorized OfficialLacy B ShawOwner/doctor · (318) 442-7787
Enumeration DateOctober 26, 2012
✔ NPI 1356694434 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOptometristEye and Vision Services Providers
Taxonomy Code152W00000X
License✔ Licensed in LA · 734-081T
Definition
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.
5615B JACKSON STREET EXT, Alexandria, LA 71303
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Other Identifiers 3

Medicaid1153486LA
Medicare UPIN48912LA
Medicare NSC0439680001LA

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter from Superior HealthPlan and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Vision Source Alexandria Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

2

Medicare enrollment records show 2 clinicians reassign Medicare billing to Vision Source Alexandria LLC, which bills Medicare for the services they deliver. Of these, 2 practice at this address. They are listed nearest first.

Clinicians, nearest first (2)

Alayna Brown, OD
Optometry
NPI 1972213197
5615B JACKSON ST
Alexandria, LA 71303
(318) 442-7787
✔ PECOS✔ Accepts MedicareSame address
Lacy Shaw, O.D.
Optometry
NPI 1265528665
5615-B JACKSON ST EXT
Alexandria, LA 71303
(318) 442-7787
✔ PECOSSame address

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Vision Source Alexandria LLC's NPI number?

The NPI number for Vision Source Alexandria LLC is 1356694434. It was assigned to this organization in the NPPES registry on October 26, 2012.

Where is Vision Source Alexandria LLC located?

Vision Source Alexandria LLC is located at 5615B Jackson Street Ext, Alexandria, LA 71303. The listed phone number is (318) 442-7787.

What is Vision Source Alexandria LLC's specialty?

The primary specialty registered for this NPI is Optometrist with taxonomy code 152W00000X.

Is Vision Source Alexandria LLC enrolled in Medicare?

Yes. Vision Source Alexandria LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Vision Source Alexandria LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians, all in Optometry, reassign their Medicare billing to Vision Source Alexandria LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 2 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does Vision Source Alexandria LLC accept?

Health plans from Ambetter Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter from Superior HealthPlan and Anthem Blue Cross and Blue Shield and 4 other insurers list Vision Source Alexandria LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Vision Source Alexandria LLC was last updated on October 26, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.