Individual provider Active NPI

Heather McBryar, O.D.

  • Optometrist
  • Hixson, TN
National Provider Identifier
1275563512
Registry record updated Jul 1, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2613 Issued in TN
Practice address
1043 Executive Dr
Suite 102
Hixson, TN 37343-3997
Phone
(423) 321-8233
NPI assigned
Jul 3, 2006
Last updated
Jul 1, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2013

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2613 TN Primary
Low Vision Rehabilitation Optometrist 152WL0500X 2613 TN
Pediatric Optometrist 152WP0200X 2613 TN
Vision Therapy Optometrist 152WV0400X 2613 TN

Addresses

Primary practice location

1043 Executive Dr
Suite 102
Hixson, TN 37343-3997

Mailing address

1043 Executive Dr
Suite 102
Hixson, TN 37343-3997
Phone (423) 321-8233

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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
I20060914000098 TN Practitioner - Optometry 6608870597 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1043 Executive Dr
Suite 102
Hixson, TN 37343-3997
Phone (423) 321-8233

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2613TNMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Southeast Vision Rehabilitation, PLLC Optometrist CurrentSince Jul 1, 2013 Accepting new patients
Pediatric Vision Associates, PLLC Optometrist PastSince Jul 29, 2005 Accepting new patients

Locations

1043 Executive Dr
Ste 102
Hixson, TN 37343
Phone (423) 321-8223

Organizations & group practices 2

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": "1151884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1372636800000",
    "number": "1275563512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1043 EXECUTIVE DR",
            "address_2": "SUITE 102",
            "city": "HIXSON",
            "state": "TN",
            "postal_code": "373433997",
            "telephone_number": "423-321-8233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1043 EXECUTIVE DR",
            "address_2": "SUITE 102",
            "city": "HIXSON",
            "state": "TN",
            "postal_code": "373433997",
            "telephone_number": "423-321-8233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCBRYAR",
        "first_name": "HEATHER",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-03",
        "last_updated": "2013-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TN",
            "license": "2613",
            "primary": true
        },
        {
            "code": "152WL0500X",
            "taxonomy_group": "",
            "desc": "Optometrist, Low Vision Rehabilitation",
            "state": "TN",
            "license": "2613",
            "primary": false
        },
        {
            "code": "152WP0200X",
            "taxonomy_group": "",
            "desc": "Optometrist, Pediatrics",
            "state": "TN",
            "license": "2613",
            "primary": false
        },
        {
            "code": "152WV0400X",
            "taxonomy_group": "",
            "desc": "Optometrist, Vision Therapy",
            "state": "TN",
            "license": "2613",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hixson, TN

Sources for this page

Verify at the official NPI Registry.