Leonard Brinkley Whiteside III, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

0618000199 Issued in VA

Practice address

12018 W Broad St
Suite 100
Henrico, VA 23233-7689

Phone

(804) 287-1380

Fax

(804) 287-1384

NPI assigned

Oct 10, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in VA

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

Specialty

Optometry

Education

Southern College of Optometry, 1990

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Myeyedr Optometry of Virginia, PLLCGroup PAC ID 0143448456, 133 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Commonwealth Vision Center P.C.

  • Optometrist
  • Blackstone, VA
  • NPI 1578651097
  Medicare reassignment NPD Authorized official
• Myeyedr Optometry of Virginia PLLC

  • Optometrist
  • Ashburn, VA
  • NPI 1174933691
  Medicare reassignment Care Compare group NPD
• Commonwealth Vision Center

  • Optometrist
  • Glen Allen, VA
  • NPI 1902982531
  NPD (past) Authorized official
• Myeyedr Optometry of Virginia, PLLC

  • Optometrist
  • Henrico, VA
  • NPI 1427704238
  NPD
• Myeyedr Optometry of Virginia, PLLC

  • Optometrist
  • North Chesterfield, VA
  • NPI 1932075983
  NPD

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

{
    "created_epoch": "1160438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1332374400000",
    "number": "1831287358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 WESTHAMPTON STA",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232263330",
            "telephone_number": "804-287-4200",
            "fax_number": "804-287-4210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12018 W BROAD ST",
            "address_2": "SUITE 100",
            "city": "HENRICO",
            "state": "VA",
            "postal_code": "232337689",
            "telephone_number": "804-287-1380",
            "fax_number": "804-287-1384"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITESIDE",
        "first_name": "LEONARD",
        "middle_name": "BRINKLEY",
        "name_suffix": "III",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-10",
        "last_updated": "2012-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "VA",
            "license": "0618000199",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "230283",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Haley White
• Jetuane White
• Lisa Marie White, MSW, LCSW
• Stacey Renae White, AGPCNP
• Wykinnya Whitehurst
• Christina Luckey Whitham, CCC-SLP
• Patience Andrea Whitson-Bender, BEHAVIOR TECHNICIAN
• Williams New Beginning WNB Support Services
• Ami Ballay Williams, LPC
• Chelsey Lynn Marie Williams, COTA/L

• Optometrist in Henrico, VA
• Providers in Henrico, VA by specialty
• Optometrist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2012; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.