Individual provider Active NPI

Kristen Elizabeth Heck, O.D.

  • Optometrist
  • Sylacauga, AL
National Provider Identifier
1003918921
Registry record updated Aug 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
S-A82-TA-661 Issued in AL
Practice address
41301 US Highway 280
Sylacauga, AL 35150-8046
Phone
(256) 245-4104
Fax
(256) 245-8668
NPI assigned
Sep 1, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 19, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X OPT.0003515 CO
Optometrist 152W00000X S-A82-TA-661 AL Primary

Addresses

Primary practice location

41301 US Highway 280
Sylacauga, AL 35150-8046

Mailing address

320 E Fontanero St
Ste 201
Colorado Springs, CO 80907-7525
Phone (719) 599-2020

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL, CO2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20041022000381 AL Practitioner - Optometry 3274594213 Practice locations: Sylacauga, AL
I20190910000708 CO Practitioner - Optometry 3274594213 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University Alabama Birmingham - School of Optometry, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Abba Eye Care PCGroup PAC ID 1355231051, 26 clinicians

Practice addresses (Care Compare)

7975 Fountain Mesa Rd
Fountain, CO 80817-1535
Phone (719) 573-2020

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-A82-TA-661ALMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Abba Eye Care PC Optometrist CurrentSince Aug 23, 2021 Accepting new patients
Abba Eye Care PC Optometrist CurrentSince Aug 23, 2021 Accepting new patients

Locations

6220 Woodmen Park Vw
Colorado Springs, CO 80923
Phone (719) 634-2020

1130 Lake Plaza Dr
Ste 130
Colorado Springs, CO 80906
Phone (719) 578-2020

7975 Fountain Mesa Rd
Fountain, CO 80817
Phone (719) 573-2020

Networks

  • devoted network organization-a4751131-f16f-4e82-8f2b-b08e66379a7a
  • CO HMO D-SNP
  • NM HMO C-SNP
  • CO HMO

Organizations & group practices 2

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": "1157068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566172800000",
    "number": "1003918921",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 E FONTANERO ST",
            "address_2": "STE 201",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809077525",
            "telephone_number": "719-599-2020",
            "fax_number": "719-632-6088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41301 US HIGHWAY 280",
            "city": "SYLACAUGA",
            "state": "AL",
            "postal_code": "351508046",
            "telephone_number": "256-245-4104",
            "fax_number": "256-245-8668"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HECK",
        "first_name": "KRISTEN",
        "middle_name": "ELIZABETH",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-01",
        "last_updated": "2019-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "CO",
            "license": "OPT.0003515",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AL",
            "license": "S-A82-TA-661",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sylacauga, AL

Sources for this page

Verify at the official NPI Registry.