Organization Active NPI

Leverett Eyecare, P.C.

  • Optometrist
  • Virginia Beach, VA
National Provider Identifier
1457412884
Registry record updated Jun 23, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
0618000402 Issued in VA
Legal business name
LEVERETT EYECARE, P.C.
Practice address
812 S Lynnhaven Rd
Suite 100
Virginia Beach, VA 23452-6313
Phone
(757) 486-2015
Fax
(757) 486-0853
NPI assigned
Dec 12, 2006
Last updated
Jun 23, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2015

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

Authorized official

Name
Marcia K Leverett, O.D.NPI 1578568283
Title
Owner
Phone
(757) 486-2015

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 0618000402 VA Primary

Addresses

Primary practice location

812 S Lynnhaven Rd
Suite 100
Virginia Beach, VA 23452-6313

Mailing address

812 S Lynnhaven Rd
Suite 100
Virginia Beach, VA 23452-6313
Phone (757) 486-2015

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100913000762 VA Part B Supplier - Clinic/Group Practice 1557486636 Receives reassigned benefits from 3 practitioners
Practice locations: Virginia Beach, VA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
49D2089987Leverett Eyecare812 S Lynnhaven Road - Suite 100, Virginia Beach, VA 23452Certificate of waiverJan 12, 2027

National Provider Directory

National Provider Directory
Tax ID family
Leverett Eyecare2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

812 S Lynnhaven Rd
#100
Virginia Beach, VA 23452
Phone (757) 486-2015

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1165881600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1435017600000",
    "number": "1457412884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "812 S LYNNHAVEN RD",
            "address_2": "SUITE 100",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234526313",
            "telephone_number": "757-486-2015",
            "fax_number": "757-486-0853"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "812 S LYNNHAVEN RD",
            "address_2": "SUITE 100",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234526313",
            "telephone_number": "757-486-2015",
            "fax_number": "757-486-0853"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEVERETT EYECARE, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-12",
        "last_updated": "2015-06-23",
        "status": "A",
        "authorized_official_last_name": "LEVERETT",
        "authorized_official_first_name": "MARCIA",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "757-486-2015",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "VA",
            "license": "0618000402",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Virginia Beach, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.