Organization Active NPI

Daniel M Eichenbaum, MD, PA

  • Ophthalmology Physician
  • Murphy, NC
National Provider Identifier
1679742845
Registry record updated Feb 21, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
000028854 Issued in NC
Legal business name
DANIEL M EICHENBAUM, MD, PA
Practice address
1321 W US Highway 64
Post Office Box 39
Murphy, NC 28906-3361
Phone
(828) 837-5404
Fax
(828) 834-5621
NPI assigned
Feb 21, 2008
Last updated
Feb 21, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2008

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

Authorized official

Name
Sheila M Clayton
Title
Office Manager
Phone
(828) 837-5404

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 000028854 NC Primary

Addresses

Primary practice location

1321 W US Highway 64
Post Office Box 39
Murphy, NC 28906-3361

Mailing address

1321 W US Highway 64
Post Office Box 39
Murphy, NC 28906-3361
Phone (828) 837-5404

Other identifiers 2

IdentifierTypeStateIssuer
8930252MedicaidNC
00380751AMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, GA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20080401000795 NC Part B Supplier - Clinic/Group Practice 1951488980 Receives reassigned benefits from 1 practitioner
Practice locations: Murphy, NC
O20080611000668 GA Part B Supplier - Clinic/Group Practice 1951488980 Receives reassigned benefits from 1 practitioner
Practice locations: Blairsville, GA; East Ellijay, GA

National Provider Directory

National Provider Directory

Locations

101 Riverstone Vis
Ste 204
Blue Ridge, GA 30513
Phone (706) 258-4130

941 Maddox Dr
Ste 236
East Ellijay, GA 30540
Phone (828) 837-5404

1321 W US Highway 64
Murphy, NC 28906
Phone (828) 837-5404

Practitioners & affiliated clinicians

Practitioners 1

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": "1203552000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1203552000000",
    "number": "1679742845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1321 W US HIGHWAY 64",
            "address_2": "POST OFFICE BOX 39",
            "city": "MURPHY",
            "state": "NC",
            "postal_code": "289063361",
            "telephone_number": "828-837-5404",
            "fax_number": "828-834-5621"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1321 W US HIGHWAY 64",
            "address_2": "POST OFFICE BOX 39",
            "city": "MURPHY",
            "state": "NC",
            "postal_code": "289063361",
            "telephone_number": "828-837-5404",
            "fax_number": "828-834-5621"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DANIEL M EICHENBAUM, MD, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-21",
        "last_updated": "2008-02-21",
        "status": "A",
        "authorized_official_last_name": "CLAYTON",
        "authorized_official_first_name": "SHEILA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "828-837-5404"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NC",
            "license": "000028854",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8930252",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00380751A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Murphy, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2008; 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.