Individual provider Active NPI

Christa Heckman, O.D.

  • Optometrist
  • Lima, OH
National Provider Identifier
1043313695
Registry record updated Dec 16, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
5555 T2465 Issued in OH
Practice address
2765 Fort Amanda Rd
Suite 100
Lima, OH 45805-4805
Phone
(419) 228-3937
Fax
(419) 882-3939
NPI assigned
Sep 7, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 5555 T2465 OH Primary

Addresses

Primary practice location

2765 Fort Amanda Rd
Suite 100
Lima, OH 45805-4805

Mailing address

718 Oakwood Dr
Minster, OH 45865-1335
Phone (419) 628-3017

Other identifiers 1

IdentifierTypeStateIssuer
2600868MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5555 T2465OHMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
John T Archer & Assoc Inc Optometrist Past Accepting new patients
Dietz Eye Care & Associates LLC Optometrist PastSince Jul 1, 2024 Accepting new patients

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": "1157587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1229385600000",
    "number": "1043313695",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "718 OAKWOOD DR",
            "city": "MINSTER",
            "state": "OH",
            "postal_code": "458651335",
            "telephone_number": "419-628-3017",
            "fax_number": "419-682-8208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2765 FORT AMANDA RD",
            "address_2": "SUITE 100",
            "city": "LIMA",
            "state": "OH",
            "postal_code": "458054805",
            "telephone_number": "419-228-3937",
            "fax_number": "419-882-3939"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HECKMAN",
        "first_name": "CHRISTA",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-07",
        "last_updated": "2008-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "5555 T2465",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2600868",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lima, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.