Individual provider Active NPI

Perry C. Motsinger, O.D.

  • Optometrist
  • Burgaw, NC
National Provider Identifier
1689622888
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1869 Issued in NC
Practice address
205 US Highway 117 S
Suite 4
Burgaw, NC 28425-6704
Phone
(910) 259-9230
Fax
(910) 259-9215
NPI assigned
May 4, 2006
Last updated
Jul 9, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1869 NC Primary

Addresses

Primary practice location

205 US Highway 117 S
Suite 4
Burgaw, NC 28425-6704

Mailing address

205 US Highway 117 S
Suite 4
Burgaw, NC 28425-6704
Phone (910) 259-9230

Other identifiers 1

IdentifierTypeStateIssuer
89093P4MedicaidNC

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
I20040710000254 NC Practitioner - Optometry 1254319791

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
1869NCMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Optometric Associates, P. a. Optometrist Past Accepting new patients
Optometric Associates, P.a. Optometrist Past Accepting new patients

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": "1146700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1689622888",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 US HIGHWAY 117 S",
            "address_2": "SUITE 4",
            "city": "BURGAW",
            "state": "NC",
            "postal_code": "284256704",
            "telephone_number": "910-259-9230",
            "fax_number": "910-259-9215"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 US HIGHWAY 117 S",
            "address_2": "SUITE 4",
            "city": "BURGAW",
            "state": "NC",
            "postal_code": "284256704",
            "telephone_number": "910-259-9230",
            "fax_number": "910-259-9215"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOTSINGER",
        "first_name": "PERRY",
        "middle_name": "C.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-04",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NC",
            "license": "1869",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89093P4",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Burgaw, NC

Sources for this page

Verify at the official NPI Registry.