NPIMap

Organization Active NPI

David R McDaniel OD PA

  • Optometrist
  • Kings MTN, NC
National Provider Identifier
1063786317
Registry record updated Mar 8, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
NC0991 Issued in NC
Legal business name
DAVID R MCDANIEL OD PA
Practice address
510 W King St
Kings MTN, NC 28086-3310
Phone
(704) 739-1394
NPI assigned
Mar 5, 2012
Last updated
Mar 8, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2012

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

Authorized official

Name
Dr. David Ronald McDaniel, ODNPI 1962460311
Title
President/Ceo
Phone
(704) 739-1394

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X NC0991 NC Primary

Addresses

Primary practice location

510 W King St
Kings MTN, NC 28086-3310

Mailing address

510 W King St
PO Box 1127
Kings MTN, NC 28086-3310
Phone (704) 739-1394

Other identifiers 2

IdentifierTypeStateIssuer
8909569MedicaidNC
246348OtherNCMEDICARE PTAN

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1330905600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1331164800000",
    "number": "1063786317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "510 W KING ST",
            "address_2": "PO BOX 1127",
            "city": "KINGS MTN",
            "state": "NC",
            "postal_code": "280863310",
            "telephone_number": "704-739-1394"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 W KING ST",
            "city": "KINGS MTN",
            "state": "NC",
            "postal_code": "280863310",
            "telephone_number": "704-739-1394"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVID R MCDANIEL OD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-05",
        "last_updated": "2012-03-08",
        "status": "A",
        "authorized_official_last_name": "MCDANIEL",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "RONALD",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "704-739-1394",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NC",
            "license": "NC0991",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8909569",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "246348",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kings MTN, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.