Active NPI
Charolette A Barnes-Leblanc, O.D.
- Optometrist
- Perris, CA
National Provider Identifier
1689785651
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 8665T
- Practice address
- 1688 N Perris Blvd
Ste L5
Perris, CA 92571-4709 - Phone
- (951) 940-8100
- Fax
- (951) 940-0780
- NPI assigned
- Aug 31, 2006
- Last updated
- Sep 22, 2017
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 8665T | CA | Primary |
Addresses
Primary practice location
1688 N Perris Blvd
Ste L5
Perris, CA 92571-4709
Mailing address
29314 Birdy CT
Nuevo, CA 92567-9493
Phone (951) 940-8100
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| SD0086651 | Medicaid | CA |
Medicare participation
Medicare enrollment files- 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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20041029000884 | CA | Practitioner - Optometry | 9830151000 | Practice locations: Perris, CA |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 8665 | CA | MD | Professional Counselor |
| 8665T | CA | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156982400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1506038400000",
"number": "1689785651",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "29314 BIRDY CT",
"city": "NUEVO",
"state": "CA",
"postal_code": "925679493",
"telephone_number": "951-940-8100"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1688 N PERRIS BLVD",
"address_2": "STE L5",
"city": "PERRIS",
"state": "CA",
"postal_code": "925714709",
"telephone_number": "951-940-8100",
"fax_number": "951-940-0780"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BARNES-LEBLANC",
"first_name": "CHAROLETTE",
"middle_name": "A",
"credential": "O.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-08-31",
"last_updated": "2017-09-22",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "CA",
"license": "8665T",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "SD0086651",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Perris, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2017; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.