Individual provider Active NPI

Ciarra Humble, OD

  • Optometrist
  • Little Elm, TX
National Provider Identifier
1396307641
Registry record updated Jul 7, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
9733T Issued in TX
Practice address
1200 E Eldorado Pkwy Ste 100
Little Elm, TX 75068-5582
Phone
(972) 292-0900
NPI assigned
Jul 7, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 9733T TX Primary

Addresses

Primary practice location

1200 E Eldorado Pkwy Ste 100
Little Elm, TX 75068-5582

Mailing address

210 Fennell Dr
Monroe, LA 71203-3926

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20190822001878 TX Practitioner - Optometry 5092043448 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9733TTXMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Little Elm Eye Care, P.a. Optometrist CurrentSince Aug 1, 2019 Accepting new patients

Locations

1200 E Eldorado Pkwy
Ste 100
Little Elm, TX 75068
Phone (972) 292-0900

Organizations & group practices 1

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": "1562457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562457600000",
    "number": "1396307641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 FENNELL DR",
            "city": "MONROE",
            "state": "LA",
            "postal_code": "712033926"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 E ELDORADO PKWY STE 100",
            "city": "LITTLE ELM",
            "state": "TX",
            "postal_code": "750685582",
            "telephone_number": "972-292-0900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUMBLE",
        "first_name": "CIARRA",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-07",
        "last_updated": "2019-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "9733T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Little Elm, TX

Sources for this page

Verify at the official NPI Registry.