Mason Williams, OD
Individual provider Active NPI Optometrist · Mooresville, NC
NPI 1629569082 · NPPES record last updated May 31, 2023
Key facts
- NPI
- 1629569082
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Optometrist 152W00000X
- License
- 2718 (NC)
- Practice address
- 197 Medical Park Rd Ste 101
Mooresville, NC 28117-8604 - Phone
- (704) 799-2233
- NPI assigned
- May 22, 2018
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 4
Medicare Care Compare profile
- Specialty
- Optometry
- Education
- Southern College of Optometry, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Lake Norman Eye OD PA
Practice addresses (Care Compare)
197 Medical Park Rd
Suite 101
Mooresville, NC 28117-8604
Phone (704) 799-2233
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Cataract surgery | 1-10 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in SC, NC
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20180922000213 | SC | Practitioner - Optometry | 3870844384 | Reassigns benefits to 1 organization |
| I20230410000523 | NC | Practitioner - Optometry | 3870844384 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2718 | NC | MD | Dentist |
| 046.011282 | IL | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| NC Doctors of Optometry PLLC | Optometrist | Current |
Accepting new patients |
| NC Doctors of Optometry PLLC | Optometrist | Current |
Accepting new patients |
| Lake Norman Eye OD PA | Optometrist | Current |
Accepting new patients |
| Brian Colletto OD, Inc | Optometrist | Current |
Accepting new patients |
Locations
8020 Northlake Creek Dr
Ste A
Charlotte, NC 28216
Phone (704) 272-3378
8561 Concord Mills Blvd
#B
Concord, NC 28027
Phone (704) 979-8234
3700 W Gate City Blvd
Greensboro, NC 27407
Phone (336) 852-6664
8830 Lindholm Dr
Ste 105
Huntersville, NC 28078
Phone (704) 494-6832
197 Medical Park Rd
Ste 101
Mooresville, NC 28117
Phone (704) 799-2233
356 Oakland Ave
Rock Hill, SC 29730
Phone (803) 890-3937
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 046.011282 | IL | |
| Optometrist | 152W00000X | 2718 | NC | Yes |
Addresses
Primary practice location
197 Medical Park Rd Ste 101
Mooresville, NC 28117-8604
Mailing address
101 Gaelic Dr
Statesville, NC 28625-2833
Phone (224) 345-8307
Other providers in Mooresville, NC
- Caitlin Williams
- Carrie Williams
- Kathy Marie Williams
- Kelly Beth Williams
- Lisa Marie Williams
- Paul H. Williams
- Princess Nicole Williams
- Randall P Williams
- Shari Fai Williams
- Takariah Willis-Finney
All providers in Mooresville, NC · Optometrist in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 31, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.