Kathy Diane Halverson, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

2457 Issued in NM

Practice address

3506 W Tyvola Rd
Charlotte, NC 28208-7201

Phone

(704) 329-1300

Fax

(704) 357-7539

NPI assigned

May 22, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

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

Specialty

Optometry

Education

Other, 1991

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ryan Leblanc OD PLLCGroup PAC ID 4981014164, 19 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Ryan Leblanc OD PLLC

  • Optometrist
  • Charlotte, NC
  • NPI 1992055966
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1148256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589760000000",
    "number": "1083669956",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "805 HAWTHORNE LN",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282042109",
            "telephone_number": "505-414-0592"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3506 W TYVOLA RD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282087201",
            "telephone_number": "704-329-1300",
            "fax_number": "704-357-7539"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALVERSON",
        "first_name": "KATHY",
        "middle_name": "DIANE",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-05-22",
        "last_updated": "2020-05-18",
        "certification_date": "2020-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "SC",
            "license": "2152",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NM",
            "license": "2457",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NC",
            "license": "2194",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Laura Jeanne Halson
• Justin Michael Halstead, DPT, ATC
• Lisa S Halstead, NP
• Courtney Lynn Halsted, RBT
• Barbara Jo Halton-Bailey, TVI
• Ashley Herrmann Ham, DO
• Grace Princess Ham
• Kayla Christine Ham, NP
• Kendra Kamera Ham, MD
• Susan Metcalf Ham, CRNA

• Optometrist in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Optometrist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.