Individual provider Active NPI

James E Harris, OD

  • Optometrist
  • Concord, NC
National Provider Identifier
1548281306
Registry record updated Dec 12, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1934 Issued in NC
Practice address
5325 Vining St.
Suite 202
Concord, NC 28027
Phone
(704) 792-2777
NPI assigned
Jul 21, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X SC1274 SC
Optometrist 152W00000X 1934 NC Primary

Addresses

Primary practice location

5325 Vining St.
Suite 202
Concord, NC 28027

Mailing address

5325 Vining St.
Suite 202
Concord, NC 28027
Phone (704) 792-2777

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
I20071213000120 NC Practitioner - Optometry 8224090360 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Modern Eye Care of Salisbury OD PAGroup PAC ID 0648335331, 2 clinicians
Modern Eye Care OD PAGroup PAC ID 3274621289, 3 clinicians

Practice addresses (Care Compare)

223 Faith Rd
Salisbury, NC 28146-7005
Phone (704) 637-7728

5325 Vinning St NW
Suite 202
Concord, NC 28027-2946
Phone (704) 792-2777

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery17

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SC1274SCMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Modern Eye Care OD PA Optometrist CurrentSince Aug 7, 2007 Accepting new patients
Park & Phillips Eye Care PA Optometrist PastSince Jan 1, 1998 Accepting new patients
Carolina Eye Care of Sumter Past Accepting new patients

Locations

5325 Vinning St NW
Ste 202
Concord, NC 28027
Phone (704) 792-2777

223 Faith Rd
Salisbury, NC 28146
Phone (704) 637-7728

Interoperability endpoints

  • Direct secure messaging: jim.harris@direct.revolutionehr.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1153440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1229040000000",
    "number": "1548281306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5325 VINING ST.",
            "address_2": "SUITE 202",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "28027",
            "telephone_number": "704-792-2777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5325 VINING ST.",
            "address_2": "SUITE 202",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "28027",
            "telephone_number": "704-792-2777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "JAMES",
        "middle_name": "E",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-21",
        "last_updated": "2008-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "SC",
            "license": "SC1274",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NC",
            "license": "1934",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Concord, NC

Sources for this page

Verify at the official NPI Registry.