Leslie Dehaven, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

2276 Issued in TN

Practice address

122 Highway 76
White House, TN 37188-9291

Phone

(615) 672-6896

Fax

(615) 672-6783

NPI assigned

Dec 21, 2006

Last updated

May 2, 2013By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Hermitage Eye Care PLLC

  • Optometrist
  • Hermitage, TN
  • NPI 1275943052
  NPD (past)

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

{
    "created_epoch": "1166659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1367452800000",
    "number": "1114081106",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "122 HIGHWAY 76",
            "city": "WHITE HOUSE",
            "state": "TN",
            "postal_code": "371889291",
            "telephone_number": "615-672-6896",
            "fax_number": "615-672-6783"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "122 HIGHWAY 76",
            "city": "WHITE HOUSE",
            "state": "TN",
            "postal_code": "371889291",
            "telephone_number": "615-672-6896",
            "fax_number": "615-672-6783"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEHAVEN",
        "first_name": "LESLIE",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-21",
        "last_updated": "2013-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TN",
            "license": "2276",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "KY",
            "license": "1510DT",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3944682",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Crossroads Sleep Center, PLLC
• Crossroads Sleep Center,PLLC
• Crossroads Urgent Care PLLC (WellNow Urgent Care of White House)
• Teri E Dean, PHARMD
• Hank D Dehaven, O.D.
• Jared A Doegey
• Travis Duke, DPT
• E & E Eyecare LLC (E & E Eyecare)
• East Nashville Aesthetic Dentistry PLLC (White House Aesthetic and Implant Dentistry)
• Alayna L Edwards

• Optometrist in White House, TN
• Providers in White House, TN by specialty
• Optometrist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2013; 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.