Individual provider Active NPI

Makayla Shore Sperbeck, OD

  • Optometrist
  • King, NC
National Provider Identifier
1215736632
Registry record updated Mar 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2856 Issued in NC
Practice address
141 Spruce Pine Way Ste C
King, NC 27021-8445
Phone
(336) 296-0012
Fax
(336) 642-5661
NPI assigned
Mar 10, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2856 NC Primary

Addresses

Primary practice location

141 Spruce Pine Way Ste C
King, NC 27021-8445

Mailing address

141 Spruce Pine Way Ste C
King, NC 27021-8445
Phone (336) 296-0012

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250418002219 NC Practitioner - Optometry 5890210181 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Magnolia Eye Care OD PLLCGroup PAC ID 9234569856, 3 clinicians

Practice addresses (Care Compare)

141 Spruce Pine Way
Suite C
King, NC 27021-8445
Phone (336) 296-0012

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2856NCMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Magnolia Eye Care, O.D. PLLC Optometrist CurrentSince Apr 11, 2025 Accepting new patients

Locations

141 Spruce Pine Way
Ste C
King, NC 27021
Phone (336) 296-0012

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.

NPI Registry JSON

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

{
    "created_epoch": "1741564800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741564800000",
    "number": "1215736632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "141 SPRUCE PINE WAY STE C",
            "city": "KING",
            "state": "NC",
            "postal_code": "270218445",
            "telephone_number": "336-296-0012",
            "fax_number": "336-642-5661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "141 SPRUCE PINE WAY STE C",
            "city": "KING",
            "state": "NC",
            "postal_code": "270218445",
            "telephone_number": "336-296-0012",
            "fax_number": "336-642-5661"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPERBECK",
        "first_name": "MAKAYLA",
        "middle_name": "SHORE",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-03-10",
        "last_updated": "2025-03-10",
        "certification_date": "2025-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NC",
            "license": "2856",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in King, NC

Sources for this page

Verify at the official NPI Registry.