Angela Stack Harris, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

1589 Issued in NC

Practice address

548 Williamson Rd
Suite 1
Mooresville, NC 28117

Phone

(704) 799-2233

Fax

(704) 799-1567

NPI assigned

Dec 7, 2005

Last updated

Jul 26, 2018By the provider in NPPES

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 1

Other names 1

• Dr. Angela Raye Stack 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

Specialty

Optometry

Education

Southern College of Optometry, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Lake Norman Eye OD PAGroup PAC ID 7012934045, 2 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: aharris@lakenormaneyecare.eyefinity-direct.com

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.

• Lake Norman Eye OD PA

  • Optometrist
  • Mooresville, NC
  • NPI 1730363144
  Medicare reassignment Care Compare group NPD Authorized official
• Patty Vision Center OD PA

  • Optometrist
  • Yanceyville, NC
  • NPI 1497798177
  NPD (past)
• Patty Vision Center OD PA

  • Optometrist
  • Burlington, NC
  • NPI 1548217755
  NPD (past)

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

{
    "created_epoch": "1133913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532563200000",
    "number": "1013992668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "548 WILLIAMSON RD STE 1",
            "city": "MOORESVILLE",
            "state": "NC",
            "postal_code": "281179111",
            "telephone_number": "704-799-2233",
            "fax_number": "704-799-1567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "548 WILLIAMSON RD",
            "address_2": "SUITE 1",
            "city": "MOORESVILLE",
            "state": "NC",
            "postal_code": "28117",
            "telephone_number": "704-799-2233",
            "fax_number": "704-799-1567"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "ANGELA",
        "middle_name": "STACK",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-07",
        "last_updated": "2018-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NC",
            "license": "1589",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "890900T",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANGELA",
            "last_name": "STACK",
            "middle_name": "RAYE",
            "prefix": "DR.",
            "credential": "OD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jodi Styons Harper, MA CCC-SLP
• Harris Enterprise of NC, Inc Dba Deal Care Inn
• Harris Teeter LLC
• Harris Teeter, LLC
• Glenda Howard Harris-RN, RN
• Paula Glover Harris, FNP
• Nzinga Ajabu Harrison, M.D.
• Kiersten Marian Hart Schneider, APRN
• Brenna Elise Hart
• Edgar O. Hartle, MD

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2018; 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.