Glenda Bottoms Secor, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

CA797T Issued in CA

Practice address

17742 Beach Blvd # 305
Huntington Beach, CA 92647-6853

Phone

(714) 596-4488

Fax

(714) 596-5522

NPI assigned

Oct 20, 2006

Last updated

Oct 15, 2010By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

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

Specialty

Optometry

Education

Indiana University - School of Optometry, 1978

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Glenda B Secor, OD, Faao, Inc

  • Optometrist
  • Huntington Beach, CA
  • NPI 1689983330
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1161302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1287100800000",
    "number": "1639252117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17742 BEACH BLVD",
            "address_2": "# 305",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926476853",
            "telephone_number": "714-596-4488",
            "fax_number": "714-596-5522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17742 BEACH BLVD # 305",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926476853",
            "telephone_number": "714-596-4488",
            "fax_number": "714-596-5522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SECOR",
        "first_name": "GLENDA",
        "middle_name": "BOTTOMS",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-20",
        "last_updated": "2010-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "CA797T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Optometrist in Huntington Beach, CA
• Providers in Huntington Beach, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.