Organization Active NPI

Carolina Eye Care OD PA

  • Optometrist
  • Cornelius, NC
National Provider Identifier
1518140672
Registry record updated Nov 12, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1865 Issued in NC
Legal business name
CAROLINA EYE CARE OD PA
Practice address
19607 W Catawba Ave
Cornelius, NC 28031-4002
Phone
(704) 892-3542
Fax
(704) 896-8528
NPI assigned
Dec 12, 2007
Last updated
Nov 12, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2012

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

Authorized official

Name
Dr. Kevin Wayne Lafone, O.D.NPI 1245289149
Title
President, Carolina Eye Care
Phone
(704) 892-3542

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1865 NC Primary

Addresses

Primary practice location

19607 W Catawba Ave
Cornelius, NC 28031-4002

Mailing address

19607 W Catawba Ave
Cornelius, NC 28031-4002
Phone (704) 892-3542

Other identifiers 2

IdentifierTypeStateIssuer
DE9560OtherNCRETIRED RAILROAD MEDICARE
1266020004OtherNCDMERC REGION C

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050315000592 NC Part B Supplier - Clinic/Group Practice 7416902267 Receives reassigned benefits from 1 practitioner
Practice locations: Cornelius, NC

National Provider Directory

National Provider Directory

Locations

19600 W Catawba Ave
Cornelius, NC 28031
Phone (704) 892-3542

19607 W Catawba Ave
Ste 101
Cornelius, NC 28031
Phone (704) 892-3542

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1197417600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1352678400000",
    "number": "1518140672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19607 W CATAWBA AVE",
            "city": "CORNELIUS",
            "state": "NC",
            "postal_code": "280314002",
            "telephone_number": "704-892-3542",
            "fax_number": "704-896-8528"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19607 W CATAWBA AVE",
            "city": "CORNELIUS",
            "state": "NC",
            "postal_code": "280314002",
            "telephone_number": "704-892-3542",
            "fax_number": "704-896-8528"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAROLINA EYE CARE OD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-12",
        "last_updated": "2012-11-12",
        "status": "A",
        "authorized_official_last_name": "LAFONE",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_middle_name": "WAYNE",
        "authorized_official_title_or_position": "PRESIDENT, CAROLINA EYE CARE",
        "authorized_official_telephone_number": "704-892-3542",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NC",
            "license": "1865",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RETIRED RAILROAD MEDICARE",
            "identifier": "DE9560",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DMERC REGION C",
            "identifier": "1266020004",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cornelius, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.