Individual provider Active NPI

Leigh Anne Green, O.D.

  • Corneal and Contact Management Optometrist
  • Waco, TX
National Provider Identifier
1447502166
Registry record updated Dec 6, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Corneal and Contact Management OptometristTaxonomy code 152WC0802X
License
5972 Issued in TX
Practice address
1215 Lake Air Dr
Waco, TX 76710-4419
Phone
(254) 752-0471
NPI assigned
Oct 4, 2012
Last updated
Dec 6, 2013By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 6, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Corneal and Contact Management Optometrist 152WC0802X 5972 TX Primary

Addresses

Primary practice location

1215 Lake Air Dr
Waco, TX 76710-4419

Mailing address

1215 Lake Air Dr
Waco, TX 76710-4419
Phone (254) 752-0471

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
I20040524001415 TX Practitioner - Optometry 7315938602 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of Houston - College of Optometry, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Green Eye Associates, PLLCGroup PAC ID 2961625694, 4 clinicians

Practice addresses (Care Compare)

201 Colonade Pkwy
Woodway, TX 76712-6174

201 Colonnade Pkwy
Waco, TX 76712-6174
Phone (254) 752-0471

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5972TXMDCorneal and Contact Management Optometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Lorraine a Fox, Crna, PC Past Accepting new patients

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": "1349308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1386288000000",
    "number": "1447502166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1215 LAKE AIR DR",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767104419",
            "telephone_number": "254-752-0471"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1215 LAKE AIR DR",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767104419",
            "telephone_number": "254-752-0471"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "LEIGH",
        "middle_name": "ANNE",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-10-04",
        "last_updated": "2013-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "TX",
            "license": "5972",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waco, TX

Sources for this page

Verify at the official NPI Registry.