Individual provider Active NPI

Deborah A Hayden, O.D.

  • Optometrist
  • Leland, NC
National Provider Identifier
1720001399
Registry record updated Nov 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1664 Issued in NC
Practice address
1031 Grandiflora Dr
Leland, NC 28451-7453
Phone
(910) 371-0540
NPI assigned
Jul 25, 2006
Last updated
Nov 3, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1664 NC Primary
Corneal and Contact Management Optometrist 152WC0802X 1664 NC

Addresses

Primary practice location

1031 Grandiflora Dr
Leland, NC 28451-7453

Mailing address

1950 Old Gallows Rd 520
Vienna, VA 22182-3970
Phone (703) 847-8899

Other practice location 1

4514 Oleander Dr
Wilmington, NC 28403-5012
Phone (910) 392-4414

Other identifiers 1

IdentifierTypeStateIssuer
890919EMedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20101229000253 NC Practitioner - Optometry 2163610502 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Indiana University School of Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1031 Grandiflora Dr
Leland, NC 28451-7453
Phone (910) 371-0540

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery43

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1664NCMDPediatric Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Myeyedr Optometry of North Carolina, PLLC Optometrist Current Accepting new patients
Myeyedr Optometry of North Carolina PLLC Optometrist CurrentSince Nov 10, 2015 Accepting new patients
Myeyedr Optometry of North Carolina, PLLC Optometrist CurrentSince Nov 10, 2015 Accepting new patients
Myeyedr Optometry of North Carolina, PLLC Optometrist Past Accepting new patients
Myeyedr Optometry of North Carolina Optometrist Past Accepting new patients
Myeyedr Optometry of North Carolina PLLC Optometrist Past Accepting new patients

Locations

1960 Randolph Rd
Charlotte, NC 28207
Phone (704) 372-5332

1031 Grandiflora Dr
Leland, NC 28451
Phone (910) 371-0540

5615 S NC 41 Hwy
Ste 300
Wallace, NC 28466
Phone (910) 285-5050

201 Racine Dr
Wilmington, NC 28403
Phone (910) 395-6050

3501 Oleander Dr
Ste 7
Wilmington, NC 28403
Phone (910) 254-9292

5619 Carolina Beach Rd
Ste 110
Wilmington, NC 28412
Phone (910) 790-0212

6825 Parker Farm Dr
Wilmington, NC 28405
Phone (910) 452-0554

1950 Old Gallows Rd
Ste 520
Vienna, VA 22182

8614 Westwood Center Dr
Fl 9
Vienna, VA 22182

Organizations & group practices 6

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": "1153785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604361600000",
    "number": "1720001399",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1950 OLD GALLOWS RD 520",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221823970",
            "telephone_number": "703-847-8899",
            "fax_number": "703-991-0514"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1031 GRANDIFLORA DR",
            "city": "LELAND",
            "state": "NC",
            "postal_code": "284517453",
            "telephone_number": "910-371-0540"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4514 Oleander Dr",
            "address_purpose": "LOCATION",
            "city": "Wilmington",
            "state": "NC",
            "postal_code": "284035012",
            "country_code": "US",
            "telephone_number": "910-392-4414",
            "fax_number": "910-392-3153",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HAYDEN",
        "first_name": "DEBORAH",
        "middle_name": "A",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-25",
        "last_updated": "2020-11-03",
        "certification_date": "2020-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NC",
            "license": "1664",
            "primary": true
        },
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "NC",
            "license": "1664",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "890919E",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Leland, NC

Sources for this page

Verify at the official NPI Registry.