Active NPI
John Bryan Marshall, OD
- Optometrist
- Chapel Hill, NC
National Provider Identifier
1104972116
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 1551
- Practice address
- 11312 US 15-501 North
Ste. 304
Chapel Hill, NC 27517-6376 - Phone
- (919) 933-6767
- Fax
- (919) 933-6732
- NPI assigned
- Jan 25, 2007
- 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 | 1551 | NC | Primary |
Addresses
Primary practice location
11312 US 15-501 North
Ste. 304
Chapel Hill, NC 27517-6376
Mailing address
11312 US 15-501 North
Ste. 304
Chapel Hill, NC 27517-6376
Phone (919) 933-6767
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8909104 | Medicaid | NC |
Medicare participation
Medicare enrollment files- 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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Optometry
- Education
- Pennsylvania College of Optometry, 1998
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
79 Falling Springs Dr
Suite 130
Chapel Hill, NC 27516-8493
Phone (919) 933-6767
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Cataract surgery | 13 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
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 and National Provider Directory roles.
-
- Optometrist
- Durham, NC
- NPI 1588619217
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169683200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1430956800000",
"number": "1104972116",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11312 US 15-501 NORTH",
"address_2": "STE. 304",
"city": "CHAPEL HILL",
"state": "NC",
"postal_code": "275176376",
"telephone_number": "919-933-6767",
"fax_number": "919-933-6732"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11312 US 15-501 NORTH",
"address_2": "STE. 304",
"city": "CHAPEL HILL",
"state": "NC",
"postal_code": "275176376",
"telephone_number": "919-933-6767",
"fax_number": "919-933-6732"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARSHALL",
"first_name": "JOHN",
"middle_name": "BRYAN",
"credential": "OD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-01-25",
"last_updated": "2015-05-07",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "NC",
"license": "1551",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8909104",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Chapel Hill, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2015; 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.