Active NPI
Charles D Register, OD
- Optometrist
- New Smyrna Beach, FL
National Provider Identifier
1053493361
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- OPC1689
- Practice address
- 103 Faulkner St
New Smyrna Beach, FL 32168-7017 - Phone
- (386) 423-7788
- Fax
- (386) 423-0035
- NPI assigned
- Oct 19, 2006
- Last updated
- May 24, 2016
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | OPC1689 | FL | Primary |
Addresses
Primary practice location
103 Faulkner St
New Smyrna Beach, FL 32168-7017
Mailing address
103 Faulkner St
New Smyrna Beach, FL 32168-7017
Phone (386) 423-7788
Medicare participation
Medicare enrollment files- 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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Optometry
- Education
- Southern College of Optometry, 1978
- Medicare assignment
- May accept Medicare assignment
- Group practices
Practice addresses (Care Compare)
103 Faulkner St
New Smyrna Beach, FL 32168-7017
Phone (386) 423-7788
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OPC1689 | FL | MD | Optometrist |
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161216000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1464048000000",
"number": "1053493361",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "103 FAULKNER ST",
"city": "NEW SMYRNA BEACH",
"state": "FL",
"postal_code": "321687017",
"telephone_number": "386-423-7788",
"fax_number": "386-423-0035"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "103 FAULKNER ST",
"city": "NEW SMYRNA BEACH",
"state": "FL",
"postal_code": "321687017",
"telephone_number": "386-423-7788",
"fax_number": "386-423-0035"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REGISTER",
"first_name": "CHARLES",
"middle_name": "D",
"credential": "OD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-19",
"last_updated": "2016-05-24",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "FL",
"license": "OPC1689",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New Smyrna Beach, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2016; 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.