Cynthia Lacy-Stallworth, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

OET009016 Issued in PA

Practice address

6331 Stenton Ave
Philadelphia, PA 19138-1129

Phone

(215) 548-5949

Fax

(215) 548-0386

NPI assigned

Jul 23, 2007

Last updated

May 3, 2017By 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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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.

• Residency Eye Care

  dba Optima Vision Center

  • Optometrist
  • Philadelphia, PA
  • NPI 1053671016
  NPD (past)

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

{
    "created_epoch": "1185148800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1493769600000",
    "number": "1265632897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6331 STENTON AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191381129",
            "telephone_number": "215-548-5949",
            "fax_number": "215-548-0836"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6331 STENTON AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191381129",
            "telephone_number": "215-548-5949",
            "fax_number": "215-548-0386"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LACY-STALLWORTH",
        "first_name": "CYNTHIA",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-23",
        "last_updated": "2017-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "06786T",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PA",
            "license": "OET009016",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Xavier Lacoste
• Ayush Lacoul, MD
• Michelle Elizabeth Lacroce, PT, DPT
• Caroline Lacroix, M.D.
• Atilano Gapuz Lacson, M.D.
• Dorottya Ilona Laczko, MD, PHD
• Asma Akbar Ladak, MD
• Shyam Ladani
• Nadine Ladd
• Lawrence J Ladden, PHD

• Optometrist in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Optometrist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2017; 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.