Individual provider Active NPI

Paul Emmet Marvin, OD

  • Optometrist
  • Charlotte, NC
National Provider Identifier
1013907492
Registry record updated Mar 31, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1322 Issued in NC
Practice address
135 S Sharon Amity Rd
Suite 100
Charlotte, NC 28211-2842
Phone
(704) 365-0555
Fax
(704) 367-8124
NPI assigned
Oct 26, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1322 NC Primary

Addresses

Primary practice location

135 S Sharon Amity Rd
Suite 100
Charlotte, NC 28211-2842

Mailing address

PO Box 60160
Charlotte, NC 28260-0160
Phone (704) 365-0555

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20100730000368 NC Practitioner - Optometry 8628101425 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
90.77 of 100Reported as group
Quality
93.64
Promoting interoperability
100
Improvement activities
40
Cost
75.59

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Horizon Eye Care, PA Optometrist CurrentSince Jan 1, 1998 Accepting new patients
Horizon Eye Care PA Optometrist PastSince Jan 1, 1998 Accepting new patients
Horizon Eye Care PA Optometrist Past Accepting new patients

Locations

11835 Southmore Dr
Charlotte, NC 28277
Phone (704) 341-3220

11010 David Taylor Dr
Charlotte, NC 28262
Phone (704) 717-0058

135 S Sharon Amity Rd
Ste 100
Charlotte, NC 28211
Phone (704) 365-0555

15419 Hodges Cir
Ste 100
Huntersville, NC 28078
Phone (704) 892-1000

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1130284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648684800000",
    "number": "1013907492",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60160",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282600160",
            "telephone_number": "704-365-0555",
            "fax_number": "704-367-8122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "135 S SHARON AMITY RD",
            "address_2": "SUITE 100",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282112842",
            "telephone_number": "704-365-0555",
            "fax_number": "704-367-8124"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARVIN",
        "first_name": "PAUL",
        "middle_name": "EMMET",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-26",
        "last_updated": "2022-03-31",
        "certification_date": "2022-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NC",
            "license": "1322",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.