NPIMap

Organization Active NPI

Morganton Eye Physicians, P.a.

  • Ambulatory Surgical Clinic/Center
  • Shelby, NC
National Provider Identifier
1417080342
Registry record updated Jun 11, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
Legal business name
MORGANTON EYE PHYSICIANS, P.A.
Practice address
1622 E Marion St
Shelby, NC 28150-4939
Phone
(704) 482-2020
Fax
(704) 482-7707
NPI assigned
Mar 13, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2012

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

Authorized official

Name
Dennis W Lee
Title
Business Manager. Meppa
Phone
(828) 433-1000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X Primary

Addresses

Primary practice location

1622 E Marion St
Shelby, NC 28150-4939

Mailing address

335 E Parker Rd
Morganton, NC 28655-5112
Phone (828) 433-1000

Other identifiers 2

IdentifierTypeStateIssuer
00602OtherNCBLUE CROSS BLUE SHIELD NC
3409894MedicaidNC

Other names 1

  • Eye Surgery Center of Shelby Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040908000657 NC Part B Supplier - Ambulatory Surgical Center 7810882818 1 other NPI on this enrollment
Practice locations: Morganton, NC; Shelby, NC

Other NPIs with the same Medicare PAC ID 7

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Care Compare: Ambulatory surgical center

Medicare Care Compare
Listed as
Morganton Eye Physicians PACCN 34C0001033
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory
Tax ID family
Optical Ctr of Morganton12 organizations share this tax ID, including this one

Other organizations with this tax ID 11

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 22

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 22

NPI Registry JSON

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

{
    "created_epoch": "1173744000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1339372800000",
    "number": "1417080342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "335 E PARKER RD",
            "city": "MORGANTON",
            "state": "NC",
            "postal_code": "286555112",
            "telephone_number": "828-433-1000",
            "fax_number": "828-433-6274"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1622 E MARION ST",
            "city": "SHELBY",
            "state": "NC",
            "postal_code": "281504939",
            "telephone_number": "704-482-2020",
            "fax_number": "704-482-7707"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MORGANTON EYE PHYSICIANS, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-13",
        "last_updated": "2012-06-11",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "DENNIS",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "BUSINESS MANAGER. MEPPA",
        "authorized_official_telephone_number": "828-433-1000"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD NC",
            "identifier": "00602",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3409894",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Eye Surgery Center of Shelby",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Shelby, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.