Organization Active NPI

Dr. Christopher J. Moshoures Optometrist PA

  • Optometrist
  • Shallotte, NC
National Provider Identifier
1093768012
Registry record updated May 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
DR. CHRISTOPHER J. MOSHOURES OPTOMETRIST PA
Practice address
208 Smith Ave
Shallotte, NC 28470-4458
Phone
(910) 754-2020
Fax
(910) 754-8811
NPI assigned
May 19, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 2, 2024

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

Authorized official

Name
Dr. Christopher J Moshoures, O.D.NPI 1770537268
Title
Owner
Phone
(910) 754-2020

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
OptometristGroup: 193200000X MULTI-SPECIALTY GROUP 152W00000X Primary

Addresses

Primary practice location

208 Smith Ave
Shallotte, NC 28470-4458

Mailing address

PO Box 867
Shallotte, NC 28459-0867
Phone (910) 754-2020

Other identifiers 3

IdentifierTypeStateIssuer
DC7507OtherNCRAILROAD MEDICARE
0158BOtherNCBLUE CROSS BCBS SHIELD OF NC
890158BMedicaidNC

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090327000586 NC Part B Supplier - Clinic/Group Practice 5193882603 Receives reassigned benefits from 9 practitioners
Practice locations: Southport, NC; Shallotte, NC; Calabash, NC

National Provider Directory

National Provider Directory

Locations

10195 Beach Dr SW
Calabash, NC 28467
Phone (910) 575-3937

208 Smith Ave
Shallotte, NC 28470
Phone (910) 754-2020

4830 Main St
Shallotte, NC 28470
Phone (910) 754-2020

Practitioners & affiliated clinicians

Practitioners 12

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1147996800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1714608000000",
    "number": "1093768012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 867",
            "city": "SHALLOTTE",
            "state": "NC",
            "postal_code": "284590867",
            "telephone_number": "910-754-2020",
            "fax_number": "910-754-8811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "208 SMITH AVE",
            "city": "SHALLOTTE",
            "state": "NC",
            "postal_code": "284704458",
            "telephone_number": "910-754-2020",
            "fax_number": "910-754-8811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. CHRISTOPHER J. MOSHOURES OPTOMETRIST PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-19",
        "last_updated": "2024-05-02",
        "certification_date": "2024-05-02",
        "status": "A",
        "authorized_official_last_name": "MOSHOURES",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "910-754-2020",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DC7507",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BCBS SHIELD OF NC",
            "identifier": "0158B",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "890158B",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Shallotte, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2024; 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.