Individual provider Active NPI

Steven Weifenbach, OD

  • Optometrist
  • Charlotte, NC
National Provider Identifier
1124542345
Registry record updated Jan 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2562 Issued in NC
Practice address
8180 S Tryon St
Charlotte, NC 28273-3325
Phone
(704) 588-9209
NPI assigned
Jul 30, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2562 NC Primary
Optometrist 152W00000X 3399 TN

Addresses

Primary practice location

8180 S Tryon St
Charlotte, NC 28273-3325

Mailing address

1105 Millbridge Rd
Belmont, NC 28012-2459
Phone (336) 749-4444

Other practice location 1

655 7th St
Robins AFB, GA 31098-2227
Phone (980) 288-5398

Other practice location 2

7735 N Tryon St
Charlotte, NC 28262-3498
Phone (704) 547-0305

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20201029000102 NC Practitioner - Optometry 9931473964 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
New England College of Optometry, 2017
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)

8180 S Tryon St
Charlotte, NC 28273-3325
Phone (704) 588-9219

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2562NCMDAddiction (Substance Use Disorder) Counselor
3399TNMDPediatric Chiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Ryan Leblanc OD PLLC Optometrist CurrentSince Sep 1, 2020 Accepting new patients

Locations

8180 S Tryon St
Charlotte, NC 28273
Phone (704) 588-9219

7735 N Tryon St
Charlotte, NC 28262
Phone (704) 547-0305

3000 E Franklin Blvd
Gastonia, NC 28056
Phone (704) 866-9599

Organizations & group practices 1

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": "1501372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705536000000",
    "number": "1124542345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1105 MILLBRIDGE RD",
            "city": "BELMONT",
            "state": "NC",
            "postal_code": "280122459",
            "telephone_number": "336-749-4444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8180 S TRYON ST",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282733325",
            "telephone_number": "704-588-9209"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "655 7th St",
            "address_purpose": "LOCATION",
            "city": "Robins AFB",
            "state": "GA",
            "postal_code": "310982227",
            "country_code": "US",
            "telephone_number": "980-288-5398",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7735 N Tryon St",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282623498",
            "country_code": "US",
            "telephone_number": "704-547-0305",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WEIFENBACH",
        "first_name": "STEVEN",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-07-30",
        "last_updated": "2024-01-18",
        "certification_date": "2024-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NC",
            "license": "2562",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TN",
            "license": "3399",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.