Individual provider Active NPI

James Lewis Marshall, OD

  • Optometrist
  • Albemarle, NC
National Provider Identifier
1306837687
Registry record updated Jan 31, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1005 Issued in NC
Practice address
1003 N 1St St
Albemarle, NC 28001-2805
Phone
(704) 983-2202
Fax
(704) 982-2202
NPI assigned
Nov 4, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 31, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1005 NC Primary

Addresses

Primary practice location

1003 N 1St St
Albemarle, NC 28001-2805

Mailing address

1003 N 1St St
Albemarle, NC 28001-2805
Phone (704) 983-2202

Other identifiers 2

IdentifierTypeStateIssuer
8909544MedicaidNC
09544OtherNCBCBS

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
I20101104000513 NC Practitioner - Optometry 1052425535 Practice locations: Albemarle, NC

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Ohio State University - College of Optometry, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1003 N 1St St
Albemarle, NC 28001-2805
Phone (704) 983-2202

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1005NCMDAcupuncturist

NPI Registry JSON

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

{
    "created_epoch": "1131062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1201737600000",
    "number": "1306837687",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1003 N 1ST ST",
            "city": "ALBEMARLE",
            "state": "NC",
            "postal_code": "280012805",
            "telephone_number": "704-983-2202",
            "fax_number": "704-982-2202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1003 N 1ST ST",
            "city": "ALBEMARLE",
            "state": "NC",
            "postal_code": "280012805",
            "telephone_number": "704-983-2202",
            "fax_number": "704-982-2202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARSHALL",
        "first_name": "JAMES",
        "middle_name": "LEWIS",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-04",
        "last_updated": "2008-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NC",
            "license": "1005",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8909544",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "09544",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Albemarle, NC

Sources for this page

Verify at the official NPI Registry.