Marcie Lyn Koontz, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

2117 Issued in NC

Practice address

2406 W Roosevelt Blvd
The Vision Center
Monroe, NC 28110-8430

Phone

(704) 588-8609

NPI assigned

Sep 16, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Marcie L. Koontz O.D. PLLC

  • Clinic/Center
  • Charlotte, NC
  • NPI 1861726861
  NPD (past) Authorized official

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

{
    "created_epoch": "1221523200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1400544000000",
    "number": "1669621553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 W. TRADE ST.",
            "address_2": "APT. 1201",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282021970",
            "telephone_number": "814-442-0437"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2406 W ROOSEVELT BLVD",
            "address_2": "THE VISION CENTER",
            "city": "MONROE",
            "state": "NC",
            "postal_code": "281108430",
            "telephone_number": "704-588-8609"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOONTZ",
        "first_name": "MARCIE",
        "middle_name": "LYN",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-09-16",
        "last_updated": "2014-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC4332",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NC",
            "license": "2117",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Knoxs House
• Knoxs House Family Care II (Knoxs House)
• Michelle Evelyn Kobe, OTR/L
• Artur Kobylas, PT
• Shannon McManus Kohnle, LMBT
• Todd Koos
• Jeffrey L Krafft, PT
• David C. Kraft, CRNA
• Rachel Kraskow, OTR
• Martin John Kreshon Jr., MD

• Optometrist in Monroe, NC
• Providers in Monroe, NC by specialty
• Optometrist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.