Individual provider Active NPI

Chelsea Spalding, O.D.

  • Optometrist
  • Port Charlotte, FL
National Provider Identifier
1790193399
Registry record updated Apr 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPC 5038 Issued in FL
Practice address
21275 Olean Blvd
Port Charlotte, FL 33952-6704
Phone
(941) 625-1325
NPI assigned
Jul 27, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPC 5038 FL Primary

Addresses

Primary practice location

21275 Olean Blvd
Port Charlotte, FL 33952-6704

Mailing address

21275 Olean Blvd
Port Charlotte, FL 33952-6704
Phone (941) 625-1325

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, TN2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20150902003014 FL Practitioner - Optometry 2264748466
I20230825002552 TN Practitioner - Optometry 2264748466 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southern College of OptometryGroup PAC ID 4587550454, 57 clinicians

Practice addresses (Care Compare)

1245 Madison Ave
Memphis, TN 38104-2211
Phone (901) 722-3385

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
3805TNMDProfessional Counselor
OPC 5038FLMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Southern College of Optometry Optometrist CurrentSince Jul 15, 2023 Accepting new patients
Southern College of Optometry Optometrist PastSince Jul 15, 2023 Accepting new patients

Locations

1350 Concourse Ave
Ste 264
Memphis, TN 38104
Phone (901) 252-3670

212 Rawlins Service Ct
Memphis, TN 38152
Phone (901) 252-3697

1245 Madison Ave
Memphis, TN 38104
Phone (901) 722-3250

Interoperability endpoints

  • Direct secure messaging: drspalding@cec.direct.eyemdemr.com

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1406419200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619049600000",
    "number": "1790193399",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21275 OLEAN BLVD",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "339526704",
            "telephone_number": "941-625-1325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21275 OLEAN BLVD",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "339526704",
            "telephone_number": "941-625-1325"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPALDING",
        "first_name": "CHELSEA",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-27",
        "last_updated": "2021-04-22",
        "certification_date": "2021-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC 5038",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Charlotte, FL

Sources for this page

Verify at the official NPI Registry.