Organization Active NPI

Allen Butler OD PA

Doing business as Family Eye Care

  • Optometrist
  • Jacksonville, NC
National Provider Identifier
1174030225
Registry record updated Jan 10, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
ALLEN BUTLER OD PA
Doing business as
Family Eye Care
Practice address
200 Doctors Dr Ste K
Jacksonville, NC 28546-6308
Phone
(910) 353-0541
Fax
(910) 353-5353
NPI assigned
Jan 10, 2018
Last updated
Jan 10, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2018

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

Authorized official

Name
Mrs. Carol Jenkins Cottle
Title
Office Manager
Phone
(910) 389-7579

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X Primary

Addresses

Primary practice location

200 Doctors Dr Ste K
Jacksonville, NC 28546-6308

Mailing address

200 Doctors Dr Ste K
Jacksonville, NC 28546-6308
Phone (910) 353-0541

Other names 1

  • Family Eye Care Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20190618000217 NC Part B Supplier - Clinic/Group Practice 2567795917 Receives reassigned benefits from 2 practitioners
Practice locations: Jacksonville, NC
O20210820001347 NC DME Supplier - Physician - General Practice 2567795917 Practice locations: Jacksonville, NC

National Provider Directory

National Provider Directory

Locations

200 Doctors Dr
Ste K
Jacksonville, NC 28546
Phone (910) 353-0541

Practitioners & affiliated clinicians

Practitioners 2

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": "1515542400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1515542400000",
    "number": "1174030225",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 DOCTORS DR STE K",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285466308",
            "telephone_number": "910-353-0541",
            "fax_number": "910-353-5353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 DOCTORS DR STE K",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285466308",
            "telephone_number": "910-353-0541",
            "fax_number": "910-353-5353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALLEN BUTLER OD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-10",
        "last_updated": "2018-01-10",
        "status": "A",
        "authorized_official_last_name": "COTTLE",
        "authorized_official_first_name": "CAROL",
        "authorized_official_middle_name": "JENKINS",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "910-389-7579",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Family Eye Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Jacksonville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2018; 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.