Individual provider Active NPI

Leslie Joan Humphrey, O.D.

  • Optometrist
  • Columbus, OH
National Provider Identifier
1255378998
Registry record updated Apr 6, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
5314/T2223 Issued in OH
Practice address
1756 W Lane Ave
Columbus, OH 43221-3311
Phone
(614) 488-3937
NPI assigned
Jun 1, 2006
Last updated
Apr 6, 2017By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 6, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 5314/T2223 OH Primary

Addresses

Primary practice location

1756 W Lane Ave
Columbus, OH 43221-3311

Mailing address

1108 Baumock Burn Dr
Columbus, OH 43235-2166
Phone (614) 310-5480

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20060920000517 OH Practitioner - Optometry 2163427428 Practice locations: Columbus, OH

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Ohio State University - College of Optometry, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1756 W Lane Ave
Columbus, OH 43221-3311
Phone (614) 488-3937

262 Neil Ave
Suite 110
Columbus, OH 43215-7314
Phone (614) 221-2020

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5314/T2223OHMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Dr Shewmaker & Associates Optometrists Inc Optometrist Past Accepting new patients
McNemar Optical, Inc. Past Accepting new patients
Dr Shewmaker & Associates Optometrists Inc Optometrist Past Accepting new patients

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": "1149120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1491436800000",
    "number": "1255378998",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1108 BAUMOCK BURN DR",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432352166",
            "telephone_number": "614-310-5480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1756 W LANE AVE",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432213311",
            "telephone_number": "614-488-3937"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUMPHREY",
        "first_name": "LESLIE",
        "middle_name": "JOAN",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-01",
        "last_updated": "2017-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "5314/T2223",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

Verify at the official NPI Registry.