Individual provider Active NPI

Christy L Larson, O.D.

  • Optometrist
  • Sanford, FL
National Provider Identifier
1821160201
Registry record updated Apr 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OP3069 Issued in FL
Practice address
5680 Wayside Dr
Sanford, FL 32771-8625
Phone
(407) 333-3937
Fax
(407) 333-4500
NPI assigned
Nov 14, 2006
Last updated
Apr 13, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OP3069 FL Primary

Addresses

Primary practice location

5680 Wayside Dr
Sanford, FL 32771-8625

Mailing address

5680 Wayside Dr
Sanford, FL 32771-8625
Phone (407) 333-3937

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20101019001485 FL Practitioner - Optometry 2668553538 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Indiana University - School of Optometry, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aeg Florida Professional PLLCGroup PAC ID 3870960032, 70 clinicians

Practice addresses (Care Compare)

5680 Wayside Dr
Sanford, FL 32771-8625
Phone (407) 333-3937

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OP3069FLMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Aeg Florida Professional PLLC Optometrist CurrentSince Dec 29, 2023 Accepting new patients
Advanced Eye Care of Central Florida Inc Optometrist CurrentSince Nov 1, 1998 Accepting new patients
DRS. Perry, Perry & Associates, Orlando, P.a. Optometrist PastSince Jul 9, 1990 Accepting new patients

Locations

4788 Hodges Blvd
Ste 205
Jacksonville, FL 32224
Phone (904) 992-9991

560 Rinehart Rd
Ste 100
Lake Mary, FL 32746
Phone (407) 333-7333

5330 SW College Rd
#O
Ocala, FL 34474
Phone (352) 512-0560

5680 Wayside Dr
Sanford, FL 32771
Phone (407) 333-3937

Organizations & group practices 3

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": "1163462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586736000000",
    "number": "1821160201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5680 WAYSIDE DR",
            "city": "SANFORD",
            "state": "FL",
            "postal_code": "327718625",
            "telephone_number": "407-333-3937",
            "fax_number": "407-333-4500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5680 WAYSIDE DR",
            "city": "SANFORD",
            "state": "FL",
            "postal_code": "327718625",
            "telephone_number": "407-333-3937",
            "fax_number": "407-333-4500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARSON",
        "first_name": "CHRISTY",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-14",
        "last_updated": "2020-04-13",
        "certification_date": "2020-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OP3069",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sanford, FL

Sources for this page

Verify at the official NPI Registry.