Active NPI
Paul A. Fine, O.D.
- Optometrist
- Charlotte, NC
National Provider Identifier
1568662104
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- NC1151
- Practice address
- 3304 Eastway Dr
Charlotte, NC 28205-5649 - Phone
- (704) 531-9147
- NPI assigned
- Jul 23, 2007
- Last updated
- Jul 23, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | NC1151 | NC | Primary |
Addresses
Primary practice location
3304 Eastway Dr
Charlotte, NC 28205-5649
Mailing address
3304 Eastway Dr
Charlotte, NC 28205-5649
Phone (704) 531-9147
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| NC1151 | NC | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1185148800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1185148800000",
"number": "1568662104",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3304 EASTWAY DR",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282055649",
"telephone_number": "704-531-9147"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3304 EASTWAY DR",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282055649",
"telephone_number": "704-531-9147"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FINE",
"first_name": "PAUL",
"middle_name": "A.",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-07-23",
"last_updated": "2007-07-23",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "NC",
"license": "NC1151",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Charlotte, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.