NPIMap

Organization Active NPI

Ryan Leblanc OD PLLC

  • Optometrist
  • Charlotte, NC
National Provider Identifier
1992055966
Registry record updated Apr 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2159 Issued in NC
Legal business name
RYAN LEBLANC OD PLLC
Practice address
7735 N Tryon St
Charlotte, NC 28262-3498
Phone
(704) 547-0305
NPI assigned
Sep 17, 2012
Last updated
Apr 17, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2023

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

Authorized official

Name
Dr. Ryan LeblancNPI 1679700371
Title
Doctor
Phone
(434) 917-1220

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2159 NC Primary

Addresses

Primary practice location

7735 N Tryon St
Charlotte, NC 28262-3498

Mailing address

505 Iverson Way
Charlotte, NC 28203-5634
Phone (704) 555-5555

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20201028002159 NC Part B Supplier - Clinic/Group Practice 4981014164 Receives reassigned benefits from 28 practitioners
Practice locations: Winston Salem, NC; Statesville, NC; Mooresville, NC; Charlotte, NC; Monroe, NC; Kernersville, NC; Kannapolis, NC; Forest City, NC…

National Provider Directory

National Provider Directory

Locations

201 Zelkova Ct NW
Conover, NC 28613
Phone (828) 464-4362

Practitioners & affiliated clinicians

Practitioners 28

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.

View all 28

NPI Registry JSON

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

{
    "created_epoch": "1347840000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1681689600000",
    "number": "1992055966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "505 IVERSON WAY",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282035634",
            "telephone_number": "704-555-5555",
            "fax_number": "704-547-0940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7735 N TRYON ST",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282623498",
            "telephone_number": "704-547-0305"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RYAN LEBLANC OD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-09-17",
        "last_updated": "2023-04-17",
        "certification_date": "2023-04-17",
        "status": "A",
        "authorized_official_last_name": "LEBLANC",
        "authorized_official_first_name": "RYAN",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "434-917-1220",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NC",
            "license": "2159",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.