NPIMap

Individual provider Active NPI

Matthew Edwin Libby, LDO

  • Optician
  • Durham, NC
National Provider Identifier
1124327093
Registry record updated Mar 17, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OpticianTaxonomy code 156FX1800X
License
1960 Issued in NC
Practice address
1105 W Chapel Hill St
Suite #3
Durham, NC 27701-3059
Phone
(919) 302-1495
NPI assigned
Mar 17, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optician 156FX1800X 1960 NC Primary

Addresses

Primary practice location

1105 W Chapel Hill St
Suite #3
Durham, NC 27701-3059

Mailing address

1105 W Chapel Hill St
Suite #3
Durham, NC 27701-3059
Phone (919) 302-1495

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1300320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1300320000000",
    "number": "1124327093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1105 W CHAPEL HILL ST",
            "address_2": "SUITE #3",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277013059",
            "telephone_number": "919-302-1495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1105 W CHAPEL HILL ST",
            "address_2": "SUITE #3",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277013059",
            "telephone_number": "919-302-1495"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIBBY",
        "first_name": "MATTHEW",
        "middle_name": "EDWIN",
        "name_prefix": "Mr.",
        "credential": "LDO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-03-17",
        "last_updated": "2011-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Optician",
            "state": "NC",
            "license": "1960",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Durham, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2011; 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.