Individual provider Active NPI

Robert Earl Nestor III, OD

  • Optometrist
  • Concord, NC
National Provider Identifier
1336832914
Registry record updated Nov 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT.007170 Issued in OH
Practice address
8111 Concord Mills Blvd Ste 359
Concord, NC 28027-6482
Phone
(980) 258-6039
Fax
(855) 978-2116
NPI assigned
May 31, 2023
Last updated
Nov 5, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPT.007170 OH Primary

Addresses

Primary practice location

8111 Concord Mills Blvd Ste 359
Concord, NC 28027-6482

Mailing address

285 Glendale St
Lagrange, OH 44050-9675
Phone (440) 387-6398

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
I20241122003690 NC Practitioner - Optometry 7113452418 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Ohio State University - College of Optometry, 2023
Medicare assignment
May accept Medicare assignment
Group practices
Corte and Wruble, OD, PLLCGroup PAC ID 5294002689, 15 clinicians

Practice addresses (Care Compare)

6801 Northlake Mall Dr
Suite 253
Charlotte, NC 28216-0757
Phone (704) 509-4490

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPT.007170OHMDOptometrist
2789NCMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Corte and Wruble, OD, PLLC Optometrist CurrentSince Sep 30, 2024 Accepting new patients

Locations

6801 Northlake Mall Dr
Ste 253
Charlotte, NC 28216
Phone (704) 509-4366

8111 Concord Mills Blvd
Ste 359
Concord, NC 28027
Phone (980) 258-6038

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, 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": "1685491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730764800000",
    "number": "1336832914",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "285 GLENDALE ST",
            "city": "LAGRANGE",
            "state": "OH",
            "postal_code": "440509675",
            "telephone_number": "440-387-6398"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8111 CONCORD MILLS BLVD STE 359",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280276482",
            "telephone_number": "980-258-6039",
            "fax_number": "855-978-2116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NESTOR",
        "first_name": "ROBERT",
        "middle_name": "EARL",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-05-31",
        "last_updated": "2024-11-05",
        "certification_date": "2024-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "OPT.007170",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Concord, NC

Sources for this page

Verify at the official NPI Registry.