Individual provider Active NPI

Coleman Harrison Lancaster Jr., O.D.

  • Optometrist
  • Louisburg, NC
National Provider Identifier
1578620175
Registry record updated Aug 23, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1420 Issued in NC
Practice address
129 Shannon VLG
Louisburg, NC 27549-2605
Phone
(919) 496-2328
NPI assigned
Jan 2, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1420 NC Primary

Addresses

Primary practice location

129 Shannon VLG
Louisburg, NC 27549-2605

Mailing address

129 S. Bickett Blvd.
Louisburg, NC 27549-2605
Phone (919) 496-2328

Other identifiers 3

IdentifierTypeStateIssuer
0262COtherNCBCBS OF NC
89012N3MedicaidNC
8802036MedicaidNC

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
I20110516000899 NC Practitioner - Optometry 1456537059 Practice locations: Lewisburg, NC

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pennsylvania College of Optometry, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

129 S Bickett Blvd
Lewisburg, NC 27549-2605
Phone (919) 496-2328

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery55

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1420NCMDHearing Instrument Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Top Pain Center CurrentSince May 16, 2011 Accepting new patients

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/EBBBDA

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1167696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1471910400000",
    "number": "1578620175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "129 S. BICKETT BLVD.",
            "city": "LOUISBURG",
            "state": "NC",
            "postal_code": "275492605",
            "telephone_number": "919-496-2328"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "129 SHANNON VLG",
            "city": "LOUISBURG",
            "state": "NC",
            "postal_code": "275492605",
            "telephone_number": "919-496-2328"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANCASTER",
        "first_name": "COLEMAN",
        "middle_name": "HARRISON",
        "name_suffix": "Jr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-02",
        "last_updated": "2016-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NC",
            "license": "1420",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF NC",
            "identifier": "0262C",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89012N3",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8802036",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisburg, NC

Sources for this page

Verify at the official NPI Registry.