Individual provider Active NPI

Matthew Jon McPheron, OD

  • Optometrist
  • Indian Trail, NC
National Provider Identifier
1639878226
Registry record updated Sep 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2761 Issued in NC
Practice address
6044 W Highway 74
Indian Trail, NC 28079-3591
Phone
(704) 821-3937
NPI assigned
Mar 2, 2023
Last updated
Sep 1, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2761 NC Primary

Addresses

Primary practice location

6044 W Highway 74
Indian Trail, NC 28079-3591

Mailing address

2263 Bryton Dr
Powell, OH 43065-7431
Phone (614) 949-9824

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
I20231031002852 NC Practitioner - Optometry 6406202118 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Premier Family Eye Care OD PLLCGroup PAC ID 8123159324, 4 clinicians
Ryan Leblanc OD PLLCGroup PAC ID 4981014164, 19 clinicians

Practice addresses (Care Compare)

6044 W Hwy 74
Indian Trail, NC 28079-3591

6467 Old Monroe Rd
Suite I
Indian Trail, NC 28079-5426
Phone (704) 821-3937

7735 N Tryon St
Charlotte, NC 28262-3498
Phone (704) 547-0305

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Family Eye Care OD PLLC Optometrist CurrentSince Sep 1, 2023 Accepting new patients
Ryan Leblanc OD PLLC Optometrist CurrentSince Jan 1, 2025 Accepting new patients
Poarch Band of Creek Indians Dba Premier Family Eye Care Optometrist Past Accepting new patients

Locations

7735 N Tryon St
Charlotte, NC 28262
Phone (704) 547-0305

6044 W Highway 74
Indian Trail, NC 28079
Phone (704) 821-3937

6467 Old Monroe Rd
Ste I
Indian Trail, NC 28079
Phone (704) 821-3937

Organizations & group practices 3

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": "1677715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693526400000",
    "number": "1639878226",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2263 BRYTON DR",
            "city": "POWELL",
            "state": "OH",
            "postal_code": "430657431",
            "telephone_number": "614-949-9824"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6044 W HIGHWAY 74",
            "city": "INDIAN TRAIL",
            "state": "NC",
            "postal_code": "280793591",
            "telephone_number": "704-821-3937"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCPHERON",
        "first_name": "MATTHEW",
        "middle_name": "JON",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-03-02",
        "last_updated": "2023-09-01",
        "certification_date": "2023-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NC",
            "license": "2761",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indian Trail, NC

Sources for this page

Verify at the official NPI Registry.