Meredith Bryne Leblanc, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

2152 Issued in NC

Practice address

640 Summit Crossing PL
Suite 202
Gastonia, NC 28054-2138

Phone

(704) 865-3937

NPI assigned

Oct 8, 2009

Sex

Female

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 2

Other names 1

• Meredith Bryne Godino Former name

Medicare fee-for-service enrollment

Enrolled in NC

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

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Ryan Leblanc OD PLLC

  • Optometrist
  • Charlotte, NC
  • NPI 1992055966
  Medicare reassignment NPD
• Eye Care Associates OD PA

  • Optometrist
  • Greensboro, NC
  • NPI 1528400223
  NPD (past)
• Eye Care Associates OD PA

  dba Eye Care Associates

  • Optometrist
  • Raleigh, NC
  • NPI 1790937720
  NPD (past)

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

{
    "created_epoch": "1254960000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1355788800000",
    "number": "1932434909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "640 SUMMIT CROSSING PL",
            "address_2": "SUITE 202",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280542138",
            "telephone_number": "704-865-3937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "640 SUMMIT CROSSING PL",
            "address_2": "SUITE 202",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280542138",
            "telephone_number": "704-865-3937"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEBLANC",
        "first_name": "MEREDITH",
        "middle_name": "BRYNE",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-10-08",
        "last_updated": "2012-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NC",
            "license": "2152",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5915268",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "157P0",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MEREDITH",
            "last_name": "GODINO",
            "middle_name": "BRYNE",
            "credential": "O.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Alysia Leak, LMFT
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• Jason Matthew Ledwak, PT

• Optometrist in Gastonia, NC
• Providers in Gastonia, NC by specialty
• Optometrist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.