George M. Conekin III, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

1181 Issued in NC

Practice address

200 Doctors Dr
Suite K
Jacksonville, NC 28546-6308

Phone

(910) 353-0541

Fax

(910) 353-5353

NPI assigned

May 2, 2006

Last updated

Dec 12, 2008By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 7

Addresses

Other identifiers 5

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

Specialty

Optometry

Education

Southern College of Optometry, 1985

Medicare assignment

May accept Medicare assignment

Group practices

Allen Butler OD PAGroup PAC ID 2567795917, 2 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Allen Butler OD PA

  dba Family Eye Care

  • Optometrist
  • Jacksonville, NC
  • NPI 1174030225
  Medicare reassignment Care Compare group NPD
• G. M. Conekin, III, OD, PA

  dba Family Eye Care

  • Optometrist
  • Jacksonville, NC
  • NPI 1447540356
  Authorized official Same address or phone

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

{
    "created_epoch": "1146528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1229040000000",
    "number": "1427016435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 DOCTORS DR",
            "address_2": "SUITE K",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285466308",
            "telephone_number": "910-353-0541",
            "fax_number": "910-353-5353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 DOCTORS DR",
            "address_2": "SUITE K",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285466308",
            "telephone_number": "910-353-0541",
            "fax_number": "910-353-5353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONEKIN",
        "first_name": "GEORGE",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-02",
        "last_updated": "2008-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NC",
            "license": "1181",
            "primary": true
        },
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "NC",
            "license": "1181",
            "primary": false
        },
        {
            "code": "152WL0500X",
            "taxonomy_group": "",
            "desc": "Optometrist, Low Vision Rehabilitation",
            "state": "NC",
            "license": "1181",
            "primary": false
        },
        {
            "code": "152WP0200X",
            "taxonomy_group": "",
            "desc": "Optometrist, Pediatrics",
            "state": "NC",
            "license": "1181",
            "primary": false
        },
        {
            "code": "152WS0006X",
            "taxonomy_group": "",
            "desc": "Optometrist, Sports Vision",
            "state": "NC",
            "license": "1181",
            "primary": false
        },
        {
            "code": "152WV0400X",
            "taxonomy_group": "",
            "desc": "Optometrist, Vision Therapy",
            "state": "NC",
            "license": "1181",
            "primary": false
        },
        {
            "code": "152WX0102X",
            "taxonomy_group": "",
            "desc": "Optometrist, Occupational Vision",
            "state": "NC",
            "license": "1181",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLIND COMMISSION ID#",
            "identifier": "Y1605",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE ID#",
            "identifier": "170000072",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE/HEALTH NET ID#",
            "identifier": "561719600",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7909328",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS ID#",
            "identifier": "09328",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Comphrensive Medical Care
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• Leigh Conant, MS, LMFT, SEP
• Susan Connor, LCSW
• Ciarra K Constant
• Consuetude
• Continuum II Home Care & Hospice, Inc. (Cardinal Hospice)
• Continuum II Home Care & Hospice, Inc.

• Optometrist in Jacksonville, NC
• Providers in Jacksonville, NC by specialty
• Optometrist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.