Charles E Heacock, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

OP0002236 Issued in FL

Practice address

840 N Stone St
Deland, FL 32720-3256

Phone

(386) 734-1766

Fax

(386) 740-7866

NPI assigned

Sep 7, 2005

Last updated

Aug 27, 2021By the provider in NPPES

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 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

Specialty

Optometry

Education

Ohio State University - College of Optometry, 1985

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Myeyedr Optometry of Florida, LLCGroup PAC ID 0143541037, 141 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

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.

• Myeyedr Optometry of Florida, LLC

  dba MyEyeDr.

  • Optometrist
  • Tallahassee, FL
  • NPI 1073907028
  Medicare reassignment Care Compare group NPD
• Total Vision of Port Orange, Inc.

  • Optometrist
  • Port Orange, FL
  • NPI 1598984676
  Medicare reassignment NPD
• Myeyedr Optometry of Florida, LLC

  dba MyEyeDr.

  • Optometrist
  • Tallahassee, FL
  • NPI 1386038339
  NPD
• Myeyedr Optometry of Florida, LLC

  • Optometrist
  • Clearwater, FL
  • NPI 1730054594
  NPD
• Myeyedr Optometry of Florida, LLC

  dba Myeyedr

  • Optometrist
  • Perry, FL
  • NPI 1437537529
  NPD (past)
• Total Vision PA

  • Optometrist
  • Debary, FL
  • NPI 1770625691
  NPD (past)

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

{
    "created_epoch": "1126051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630022400000",
    "number": "1942294905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1950 OLD GALLOWS RD STE 520",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221823970",
            "telephone_number": "703-847-8899",
            "fax_number": "571-223-6780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "840 N STONE ST",
            "city": "DELAND",
            "state": "FL",
            "postal_code": "327203256",
            "telephone_number": "386-734-1766",
            "fax_number": "386-740-7866"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEACOCK",
        "first_name": "CHARLES",
        "middle_name": "E",
        "name_prefix": "Mr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-07",
        "last_updated": "2021-08-27",
        "certification_date": "2021-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OP0002236",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "078734500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Christopher Harvey, ATC, LAT
• Marissa L Hawley, RCSWI
• Dashia Rashawn Haws
• Jessica Lea Hayes, ARNP
• Stephen W Hayman, D.C.
• Stephanie MN Healey, RBT
• Healing Home Health Agency LLC
• Healthcare Services Inc. (Dependable Nightingales Agency)
• Hearing Healthcare Solutions, Inc. (Audibel Hearing Center)
• Heart Peace Counseling Center LLC

• Optometrist in Deland, FL
• Providers in Deland, FL by specialty
• Optometrist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2021; 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.