Active NPI
Michael Barry Beckerman, O.D.
- Optometrist
- Weaverville, NC
National Provider Identifier
1245557487
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 0852
- Practice address
- 6 Weaverville Plaza
Weaverville, NC 28787 - Phone
- (828) 658-2901
- NPI assigned
- Apr 28, 2010
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 0852 | NC | Primary |
| Optometrist | 152W00000X | 503 | SC |
Addresses
Primary practice location
6 Weaverville Plaza
Weaverville, NC 28787
Mailing address
110 Pinnacle Peak LN
Flat Rock, NC 28731-8559
Phone (828) 698-8083
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 093K6 | Medicaid | NC |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 503 | SC | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1272412800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1272412800000",
"number": "1245557487",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "110 PINNACLE PEAK LN",
"city": "FLAT ROCK",
"state": "NC",
"postal_code": "287318559",
"telephone_number": "828-698-8083"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6 WEAVERVILLE PLAZA",
"city": "WEAVERVILLE",
"state": "NC",
"postal_code": "28787",
"telephone_number": "828-658-2901"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BECKERMAN",
"first_name": "MICHAEL",
"middle_name": "BARRY",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2010-04-28",
"last_updated": "2010-04-28",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "NC",
"license": "0852",
"primary": true
},
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "SC",
"license": "503",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "093K6",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Weaverville, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.