Individual provider Active NPI

Charlotte Leigh Burns, O.D.

  • Optometrist
  • Dallas, TX
National Provider Identifier
1285689877
Registry record updated Oct 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
07352T Issued in TX
Practice address
5920 Encore Dr
Dallas, TX 75240-4760
Phone
(972) 607-5978
NPI assigned
May 23, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 07352T TX Primary
Optometrist 152W00000X 2654 WI

Addresses

Primary practice location

5920 Encore Dr
Dallas, TX 75240-4760

Mailing address

5920 Encore Dr
Dallas, TX 75240-4760
Phone (972) 607-5978

Other identifiers 1

IdentifierTypeStateIssuer
38707300MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2654WIMDClinical Social Worker
07352TTXMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
North Texas Vision Care, LLC Optometrist CurrentSince Oct 19, 2020 Accepting new patients
Neuropain Solutions LLC Current Accepting new patients
Excel Performance Medical Center PastSince Sep 10, 2013 Accepting new patients
Neuropain Solutions LLC PastSince Nov 10, 2013 Accepting new patients
WCML Management Services, LLC PastSince Jun 23, 2012 Accepting new patients
Neuropain Solutions LLC PastSince Jun 26, 2013 Accepting new patients

Locations

730 W Exchange Pkwy
Allen, TX 75013
Phone (469) 854-6711

Organizations & group practices 6

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": "1148342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602547200000",
    "number": "1285689877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5920 ENCORE DR",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752404760",
            "telephone_number": "972-607-5978"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5920 ENCORE DR",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752404760",
            "telephone_number": "972-607-5978"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURNS",
        "first_name": "CHARLOTTE",
        "middle_name": "LEIGH",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-23",
        "last_updated": "2020-10-13",
        "certification_date": "2020-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "07352T",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WI",
            "license": "2654",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38707300",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2020; 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.