NPIMap

Individual provider Active NPI

David M Noonan, OD

  • Optometrist
  • Mooresville, NC
National Provider Identifier
1225088503
Registry record updated Apr 21, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1587 Issued in NC
Practice address
169 Norman Station Blvd
Mooresville, NC 28117-6396
Phone
(704) 663-3796
Fax
(704) 663-4679
NPI assigned
May 10, 2006
Last updated
Apr 21, 2009By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 21, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1587 NC Primary

Addresses

Primary practice location

169 Norman Station Blvd
Mooresville, NC 28117-6396

Mailing address

18419 Dembridge Dr
Davidson, NC 28036-7819
Phone (704) 892-3817

Other identifiers 3

IdentifierTypeStateIssuer
093G0OtherNCBCBS
NOONAN DAVID M 10028OtherNCOPTICARE
NVAL28224OtherNCSPECTERA

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
1587NCMDSchool Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Charlotte Optometry Group PA Optometrist Past Accepting new patients
Dr. David M. Noonan OD & Associates PastSince Jan 1, 1990 Accepting new patients
Visionworks, Inc PastSince Mar 21, 2015 Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1147219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1240272000000",
    "number": "1225088503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18419 DEMBRIDGE DR",
            "city": "DAVIDSON",
            "state": "NC",
            "postal_code": "280367819",
            "telephone_number": "704-892-3817"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "169 NORMAN STATION BLVD",
            "city": "MOORESVILLE",
            "state": "NC",
            "postal_code": "281176396",
            "telephone_number": "704-663-3796",
            "fax_number": "704-663-4679"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOONAN",
        "first_name": "DAVID",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-10",
        "last_updated": "2009-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NC",
            "license": "1587",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "093G0",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OPTICARE",
            "identifier": "NOONAN DAVID M 10028",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SPECTERA",
            "identifier": "NVAL28224",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mooresville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2009; 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.