Individual provider Active NPI

Andrew Jason Harris, O.D.

  • Optometrist
  • Greenville, NC
National Provider Identifier
1396830840
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2026 Issued in NC
Practice address
499 Greenville Blvd SE
Greenville, NC 27858-6734
Phone
(252) 756-9404
NPI assigned
Oct 3, 2006
Last updated
Mar 17, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 0618001599 VA
Optometrist 152W00000X 2026 NC Primary

Addresses

Primary practice location

499 Greenville Blvd SE
Greenville, NC 27858-6734

Mailing address

1950 Old Gallows Rd
Suite 520
Vienna, VA 22182-3990
Phone (703) 847-8899

Other practice location 1

1950 Old Gallows Rd
Suite 520
Vienna, VA 22182-3990
Phone (703) 847-8899

Other identifiers 4

IdentifierTypeStateIssuer
5905646MedicaidNC
093VGOtherNCBCBS PROV #
239958OtherVAANTHEM PROVIDER NUMBER
010320445MedicaidVA

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
I20070207000528 NC Practitioner - Optometry 6709884653 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pennsylvania College of Optometry, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1960 Randolph Rd
Charlotte, NC 28207-1129
Phone (704) 372-5332

499 Greenville Blvd SE
Greenville, NC 27858-6734
Phone (252) 756-9404

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery30

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0618001599VAMDOptometrist
2026NCMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Myeyedr Optometry of North Carolina, PLLC Optometrist Current Accepting new patients
Myeyedr Optometry of North Carolina, PLLC Optometrist CurrentSince Jan 4, 2014 Accepting new patients
Myeyedr Optometry of North Carolina, PLLC Optometrist CurrentSince Jan 4, 2014 Accepting new patients
Myeyedr Optometry of North Carolina Optometrist Past Accepting new patients

Locations

1960 Randolph Rd
Charlotte, NC 28207
Phone (704) 372-5332

1840 W Arlington Blvd
Greenville, NC 27834
Phone (252) 752-2171

2490 Stantonsburg Rd
Greenville, NC 27834
Phone (252) 752-4844

499 Greenville Blvd SE
Greenville, NC 27858
Phone (252) 756-9404

601 Greenville Blvd SE
Greenville, NC 27858
Phone (252) 756-4204

3001 Martin Luther King Jr Blvd
New Bern, NC 28562
Phone (252) 633-2901

13220 Strickland Rd
Ste 160
Raleigh, NC 27613
Phone (919) 870-6430

3905 New Bern Ave
Raleigh, NC 27610
Phone (919) 231-6040

901 N Winstead Ave
Ste 190
Rocky Mount, NC 27804
Phone (252) 355-7301

1302 Brown St
Washington, NC 27889
Phone (252) 633-2901

1950 Old Gallows Rd
Ste 520
Vienna, VA 22182

8614 Westwood Center Dr
Fl 9
Vienna, VA 22182

Organizations & group practices 4

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": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1396830840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1950 OLD GALLOWS RD",
            "address_2": "SUITE 520",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221823990",
            "telephone_number": "703-847-8899",
            "fax_number": "703-991-0514"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "499 GREENVILLE BLVD SE",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278586734",
            "telephone_number": "252-756-9404"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1950 Old Gallows Rd",
            "address_2": "Suite 520",
            "address_purpose": "LOCATION",
            "city": "Vienna",
            "state": "VA",
            "postal_code": "221823990",
            "country_code": "US",
            "telephone_number": "703-847-8899",
            "fax_number": "703-991-0514",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "ANDREW",
        "middle_name": "JASON",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-03",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "VA",
            "license": "0618001599",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NC",
            "license": "2026",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5905646",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROV #",
            "identifier": "093VG",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM PROVIDER NUMBER",
            "identifier": "239958",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010320445",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, NC

Sources for this page

Verify at the official NPI Registry.