G. M. Conekin, III, OD, PA

Primary specialty

OptometristTaxonomy code 152W00000X

License

1181 Issued in NC

Legal business name

G. M. CONEKIN, III, OD, PA

Practice address

200 Doctors Dr
Suite K
Jacksonville, NC 28546-6310

Phone

(910) 353-0541

Fax

(910) 353-5353

NPI assigned

Apr 12, 2011

Organization subpart

No

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

Authorized official

Name

Dr. George M. Conekin III, OD

Title

Owner

Phone

(910) 353-0541

Specialties & licenses 11

Addresses

Other identifiers 4

Other names 1

• Family Eye Care Doing business as

Practitioners 1

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

• Lloyd Allen Butler, O.D.

  • Optometrist
  • Jacksonville, NC
  • NPI 1396904132
  NPD (past)

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

{
    "created_epoch": "1302566400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1302566400000",
    "number": "1447540356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 DOCTORS DRIVE",
            "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": "285466310",
            "telephone_number": "910-353-0541",
            "fax_number": "910-353-5353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "G. M. CONEKIN, III, OD, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-04-12",
        "last_updated": "2011-04-12",
        "status": "A",
        "authorized_official_last_name": "CONEKIN",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "910-353-0541",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "NC",
            "license": "1181",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "NC",
            "license": "2082",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "NC",
            "license": "2122",
            "primary": false
        },
        {
            "code": "152WC0802X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "NC",
            "license": "2082",
            "primary": false
        },
        {
            "code": "152WC0802X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "NC",
            "license": "2122",
            "primary": false
        },
        {
            "code": "152WL0500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist, Low Vision Rehabilitation",
            "state": "NC",
            "license": "1181",
            "primary": false
        },
        {
            "code": "152WP0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist, Pediatrics",
            "state": "NC",
            "license": "1181",
            "primary": false
        },
        {
            "code": "152WP0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist, Pediatrics",
            "state": "NC",
            "license": "2082",
            "primary": false
        },
        {
            "code": "152WP0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist, Pediatrics",
            "state": "NC",
            "license": "2122",
            "primary": false
        },
        {
            "code": "152WS0006X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist, Sports Vision",
            "state": "NC",
            "license": "1181",
            "primary": false
        },
        {
            "code": "152WV0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist, Vision Therapy",
            "state": "NC",
            "license": "1181",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "09328",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "170000072",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLIND COMMISSION",
            "identifier": "Y1605",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7909328",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Family Eye Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Otosha Moore Fryar
• Justine Fuentes
• Olivia Anne Fuhrman, M.A. CCC-SLP
• Morgan Fuller
• Stephen Craig Futrell, DDS
• Warren F Gabaree Jr., DDS, MED
• Erik Gable, PHARMD
• Taylor Shea Gaffney, PHARMD
• Mary Kathleen Galbraith
• Eric Shannon Gallagher

• 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 Apr 12, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.