Individual provider Active NPI

Anthony Fioravanti, OD

  • Optometrist
  • Charlotte, NC
National Provider Identifier
1558710103
Registry record updated Apr 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2455 Issued in NC
Practice address
326 S Sharon Amity Rd
Charlotte, NC 28211-2806
Phone
(704) 365-6477
Fax
(336) 944-6745
NPI assigned
Jun 5, 2016
Last updated
Apr 8, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2455 NC Primary

Addresses

Primary practice location

326 S Sharon Amity Rd
Charlotte, NC 28211-2806

Mailing address

4456 Randolph Rd
Charlotte, NC 28211-2326
Phone (704) 365-6477

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
I20211104000022 NC Practitioner - Optometry 7214325661 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Insightful Eye Care Doctors of Optometry PLLCGroup PAC ID 8022461375, 2 clinicians

Practice addresses (Care Compare)

326 S Sharon Amity Rd
Charlotte, NC 28211-2806
Phone (704) 365-6477

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2455NCMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Insightful Eye Care, Doctors of Optometry, PLLC Optometrist CurrentSince Jan 26, 2024 Accepting new patients

Locations

326 S Sharon Amity Rd
Charlotte, NC 28211
Phone (704) 365-6277

4456 Randolph Rd
Charlotte, NC 28211
Phone (704) 365-6277

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1465084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744070400000",
    "number": "1558710103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4456 RANDOLPH RD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282112326",
            "telephone_number": "704-365-6477"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "326 S SHARON AMITY RD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282112806",
            "telephone_number": "704-365-6477",
            "fax_number": "336-944-6745"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FIORAVANTI",
        "first_name": "ANTHONY",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-06-05",
        "last_updated": "2025-04-08",
        "certification_date": "2025-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NC",
            "license": "2455",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.