Philip Burton Funderburk, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

922 Issued in NC

Practice address

7749 Matthews Mint Hill Rd
Mint Hill, NC 28227-7598

Phone

(704) 545-9797

Fax

(704) 545-3111

NPI assigned

Mar 20, 2007

Last updated

Nov 14, 2017By the provider in NPPES

Sex

Male

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

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

Illinois College of Optometry at Chicago, 1976

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Myeyedr Optometry of North Carolina PLLCGroup PAC ID 6608019096, 167 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Myeyedr Optometry of North Carolina, PLLC

  dba MyEyeDr

  • Optometrist
  • Charlotte, NC
  • NPI 1023183563
  Medicare reassignment Care Compare group NPD
• DRS. Funderburk & Price, OD PA

  dba Bessemer City Eyecare

  • Optometrist
  • Bessemer City, NC
  • NPI 1528305760
  NPD (past) Authorized official
• DRS. Funderburk and Price, OD

  • Optometrist
  • Mint Hill, NC
  • NPI 1700050366
  NPD (past) Authorized official
• Myeyedr Optometry of North Carolina, PLLC

  dba MyEyeDr

  • Optometrist
  • Kannapolis, NC
  • NPI 1194152017
  NPD
• Myeyedr Optometry of North Carolina, PLLC

  • Optometrist
  • Monroe, NC
  • NPI 1407737182
  NPD
• Crown Point Eyecare, OD PA

  • Optometrist
  • Charlotte, NC
  • NPI 1851638100
  NPD (past)
• Myeyedr Optometry of North Carolina

  dba MyEyeDr

  • Optometrist
  • Charlotte, NC
  • NPI 1700851045
  NPD (past)
• Myeyedr Optometry of North Carolina, PLLC

  dba MyEyeDr.

  • Optometrist
  • Charlotte, NC
  • NPI 1972559235
  NPD (past)

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

{
    "created_epoch": "1174348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1510617600000",
    "number": "1093830135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1950 OLD GALLOWS RD",
            "address_2": "520",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221823990",
            "telephone_number": "703-847-8899",
            "fax_number": "703-991-0514"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7749 MATTHEWS MINT HILL RD",
            "city": "MINT HILL",
            "state": "NC",
            "postal_code": "282277598",
            "telephone_number": "704-545-9797",
            "fax_number": "704-545-3111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FUNDERBURK",
        "first_name": "PHILIP",
        "middle_name": "BURTON",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-20",
        "last_updated": "2017-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NC",
            "license": "922",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8909297",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Optometrist in Mint Hill, NC
• Providers in Mint Hill, NC by specialty
• Optometrist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2017; 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.