Organization Active NPI

Van G. Dellinger, OD, PA

  • Optometrist
  • Cherryville, NC
National Provider Identifier
1639340979
Registry record updated Dec 2, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1182 Issued in NC
Legal business name
VAN G. DELLINGER, OD, PA
Practice address
201 W Church St
Cherryville, NC 28021-2805
Phone
(704) 435-2020
Fax
(704) 435-5267
NPI assigned
Mar 14, 2008
Last updated
Dec 2, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2009

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

Authorized official

Name
Dr. Van G Dellinger, ODNPI 1467536821
Title
Optometrist
Phone
(704) 435-2020

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Eyewear Supplier 332H00000X 1182 NC
Optometrist 152W00000X 1182 NC Primary

Addresses

Primary practice location

201 W Church St
Cherryville, NC 28021-2805

Mailing address

PO Box 160
Cherryville, NC 28021-0160
Phone (704) 435-2020

Other identifiers 2

IdentifierTypeStateIssuer
7909223MedicaidNC
09223OtherNCBCBS PROVIDER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100826000751 NC Part B Supplier - Clinic/Group Practice 2062536105 Receives reassigned benefits from 3 practitioners
Practice locations: Cherryville, NC

National Provider Directory

National Provider Directory

Locations

201 W Church St
Cherryville, NC 28021
Phone (704) 425-2020

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1205452800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1259712000000",
    "number": "1639340979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 160",
            "city": "CHERRYVILLE",
            "state": "NC",
            "postal_code": "280210160",
            "telephone_number": "704-435-2020",
            "fax_number": "704-435-5267"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 W CHURCH ST",
            "city": "CHERRYVILLE",
            "state": "NC",
            "postal_code": "280212805",
            "telephone_number": "704-435-2020",
            "fax_number": "704-435-5267"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VAN G. DELLINGER, OD, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-14",
        "last_updated": "2009-12-02",
        "status": "A",
        "authorized_official_last_name": "DELLINGER",
        "authorized_official_first_name": "VAN",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "704-435-2020",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "NC",
            "license": "1182",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NC",
            "license": "1182",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7909223",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER",
            "identifier": "09223",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cherryville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.