Individual provider Active NPI

Lea Kay Spears, O.D.

  • Optometrist
  • Crestview, FL
National Provider Identifier
1235387671
Registry record updated Aug 24, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPC4350 Issued in FL
Practice address
207 N Main St
Crestview, FL 32536-3543
Phone
(850) 683-0221
Fax
(850) 683-0225
NPI assigned
Aug 27, 2008
Last updated
Aug 24, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPC4350 FL Primary

Addresses

Primary practice location

207 N Main St
Crestview, FL 32536-3543

Mailing address

207 N Main St
Crestview, FL 32536-3543
Phone (850) 683-0221

Other identifiers 2

IdentifierTypeStateIssuer
02237OtherFLBLUE CROSS AND BLUE SHIELD OF FLORIDA
000859600MedicaidFL

Other names 1

  • Lea Kay McCormick Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20081204000346 FL Practitioner - Optometry 4385705730 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPC4350FLMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Family First Vision Care, PLLC Optometrist CurrentSince May 24, 2024 Accepting new patients
Okaloosa Eye Care PA Optometrist PastSince May 16, 2005 Accepting new patients
Eye Care Physicians Inc Past Accepting new patients

Locations

4418 Commons Dr E
Ste A
Destin, FL 32541
Phone (850) 654-3937

359 Marsh Landing Pkwy
Jacksonville Beach, FL 32250
Phone (904) 280-0011

11570 Panama City Beach Pkwy
Ste 100
Panama City Beach, FL 32407
Phone (850) 230-4433

316 S Hamilton Rd
Gahanna, OH 43230

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": "1219795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1314144000000",
    "number": "1235387671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "207 N MAIN ST",
            "city": "CRESTVIEW",
            "state": "FL",
            "postal_code": "325363543",
            "telephone_number": "850-683-0221",
            "fax_number": "850-683-0225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "207 N MAIN ST",
            "city": "CRESTVIEW",
            "state": "FL",
            "postal_code": "325363543",
            "telephone_number": "850-683-0221",
            "fax_number": "850-683-0225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPEARS",
        "first_name": "LEA",
        "middle_name": "KAY",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-27",
        "last_updated": "2011-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC4350",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS AND BLUE SHIELD OF FLORIDA",
            "identifier": "02237",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000859600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LEA",
            "last_name": "MCCORMICK",
            "middle_name": "KAY",
            "credential": "O.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Crestview, FL

Sources for this page

Verify at the official NPI Registry.