NPIMap

Organization Active NPI

Heritage Eye Care

  • Optometrist
  • Madison, AL
National Provider Identifier
1720506876
Registry record updated Apr 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
S-993-TA-554 Issued in AL
Legal business name
HERITAGE EYE CARE
Doing business as
Heritage Eye Care
Practice address
12181 County Line Rd Ste 190
Madison, AL 35758-7739
Phone
(256) 233-5454
NPI assigned
Sep 8, 2017
Last updated
Apr 28, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2022

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

Authorized official

Name
Dr. Chad L Davis, ODNPI 1750348868
Title
Owner
Phone
(256) 233-2393

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X S-993-TA-554 AL Primary

Addresses

Primary practice location

12181 County Line Rd Ste 190
Madison, AL 35758-7739

Mailing address

PO Box 1189
Athens, AL 35612-1189

Other names 1

  • Heritage Eye Care Doing business as

National Provider Directory

National Provider Directory

Locations

12090 County Line Rd
Ste O
Madison, AL 35756
Phone (256) 233-2393

Practitioners & affiliated clinicians

Practitioners 2

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": "1504828800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1651104000000",
    "number": "1720506876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1189",
            "city": "ATHENS",
            "state": "AL",
            "postal_code": "356121189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12181 COUNTY LINE RD STE 190",
            "city": "MADISON",
            "state": "AL",
            "postal_code": "357587739",
            "telephone_number": "256-233-5454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HERITAGE EYE CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-09-08",
        "last_updated": "2022-04-28",
        "certification_date": "2022-04-28",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "CHAD",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "256-233-2393",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AL",
            "license": "S-993-TA-554",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Heritage Eye Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Madison, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.