Organization Active NPI

Heffington Optical Company Inc

Doing business as OptiLand

  • Optician
  • Springfield, MO
National Provider Identifier
1912052176
Registry record updated Mar 2, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
OpticianTaxonomy code 156FX1800X
Legal business name
HEFFINGTON OPTICAL COMPANY INC
Doing business as
OptiLand
Practice address
640 W Chestnut St
Springfield, MO 65806-1016
Phone
(417) 869-3937
Fax
(417) 869-0281
NPI assigned
Jan 25, 2007
Last updated
Mar 2, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2016

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

Authorized official

Name
Deborah Heffington
Title
Accounting
Phone
(417) 869-3937

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optician 156FX1800X NU Primary

Addresses

Primary practice location

640 W Chestnut St
Springfield, MO 65806-1016

Mailing address

PO Box 774
Springfield, MO 65801-0774
Phone (417) 869-3937

Other identifiers 1

IdentifierTypeStateIssuer
322243700MedicaidMO

Other names 1

  • OptiLand Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20100930027041 MO DME Supplier - Physician - OptometristDME Supplier - Optician 3577682160 Practice locations: Springfield, MO
O20110718000138 MO Part B Supplier - Clinic/Group Practice 3577682160 Receives reassigned benefits from 8 practitioners
Practice locations: Springfield, MO

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
26D2218443Heffington Optical Company Inc640 W Chestnut St, Springfield, MO 65806Certificate of waiverMar 28, 2027

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Heffington Optical Co Inc640 W Chestnut St, Springfield, MO 65806-1016(417) 869-3937 Prosthetic Lenses: Conventional Eyeglasses Accepts assignmentParticipating since Jan 1, 1998

National Provider Directory

National Provider Directory

Locations

640 W Chestnut St
Springfield, MO 65806
Phone (417) 869-3937

Practitioners & affiliated clinicians

Practitioners 9

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": "1169683200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1456876800000",
    "number": "1912052176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 774",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658010774",
            "telephone_number": "417-869-3937",
            "fax_number": "417-869-0281"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "640 W CHESTNUT ST",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658061016",
            "telephone_number": "417-869-3937",
            "fax_number": "417-869-0281"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEFFINGTON OPTICAL COMPANY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-25",
        "last_updated": "2016-03-02",
        "status": "A",
        "authorized_official_last_name": "HEFFINGTON",
        "authorized_official_first_name": "DEBORAH",
        "authorized_official_title_or_position": "ACCOUNTING",
        "authorized_official_telephone_number": "417-869-3937"
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Optician",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "322243700",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "OptiLand",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Springfield, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.