Individual provider Active NPI

Cynthia Gale Heard, O.D.

  • Optometrist
  • Memphis, TN
National Provider Identifier
1063463941
Registry record updated Dec 15, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2786 Issued in TN
Practice address
1225 Madison Ave
Memphis, TN 38104-2211
Phone
(901) 722-3250
NPI assigned
May 15, 2006
Last updated
Dec 15, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2786 TN Primary

Addresses

Primary practice location

1225 Madison Ave
Memphis, TN 38104-2211

Mailing address

1245 Madison Ave
Memphis, TN 38104-2211
Phone (901) 722-3265

Other names 1

  • Dr. Cynthia Heard Green Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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 1

Enrollment IDStateProvider typePAC IDDetails
I20080218000063 TN Practitioner - Optometry 8628096096 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Ohio State University - College of Optometry, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southern College of OptometryGroup PAC ID 4587550454, 57 clinicians

Practice addresses (Care Compare)

1245 Madison Ave
Memphis, TN 38104-2211
Phone (901) 722-3385

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Southern College of Optometry Optometrist CurrentSince Nov 15, 2007 Accepting new patients
Southern College of Optometry Optometrist PastSince Nov 15, 2007 Accepting new patients
Ohio State University Past Accepting new patients

Locations

1225 Madison Ave
Memphis, TN 38104
Phone (901) 722-3250

1245 Madison Ave
Memphis, TN 38104
Phone (901) 722-3250

212 Rawlins Service Ct
Memphis, TN 38152
Phone (901) 252-3697

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1147651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1292371200000",
    "number": "1063463941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1245 MADISON AVE",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381042211",
            "telephone_number": "901-722-3265"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1225 MADISON AVE",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381042211",
            "telephone_number": "901-722-3250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEARD",
        "first_name": "CYNTHIA",
        "middle_name": "GALE",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-15",
        "last_updated": "2010-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TN",
            "license": "2786",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CYNTHIA",
            "last_name": "GREEN",
            "middle_name": "HEARD",
            "prefix": "DR.",
            "credential": "O.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Memphis, TN

Sources for this page

Verify at the official NPI Registry.