Timothy James Hennie, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

1071 Issued in NC

Practice address

1910 Jake Alexander Blvd W
Suite 101
Salisbury, NC 28147-1163

Phone

(704) 633-2581

Fax

(704) 633-2592

NPI assigned

May 3, 2006

Last updated

Feb 27, 2013By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Specialty

Optometry

Education

Ohio State University - College of Optometry, 1981

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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 North Carolina PLLC

  dba MyEyeDr.

  • Optometrist
  • Salisbury, NC
  • NPI 1760094601
  NPD (past)

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

{
    "created_epoch": "1146614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1361923200000",
    "number": "1972561306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1910 JAKE ALEXANDER BLVD W",
            "address_2": "SUITE 101",
            "city": "SALISBURY",
            "state": "NC",
            "postal_code": "281471162",
            "telephone_number": "704-633-2581",
            "fax_number": "704-633-2592"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1910 JAKE ALEXANDER BLVD W",
            "address_2": "SUITE 101",
            "city": "SALISBURY",
            "state": "NC",
            "postal_code": "281471163",
            "telephone_number": "704-633-2581",
            "fax_number": "704-633-2592"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENNIE",
        "first_name": "TIMOTHY",
        "middle_name": "JAMES",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-03",
        "last_updated": "2013-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NC",
            "license": "1071",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• James Helms, CRNA
• Ilisa Henderson, MSW LCSWA
• Kimberly Henderson, RPH
• Alexis Branch Henley, DPT
• Mary Fisher Henley, FNP-C
• Michelle Buie Henrickson, RD
• Henrys Haven Pathways LLC
• Brett R. Henson, DDS
• Heritage Center, LLC (Heritage Plantation)
• Vicky Lucia Herrick

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2013; 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.