Individual provider Active NPI

Mark Moseley Sikes, O.D.

  • Optometrist
  • Charlotte, NC
National Provider Identifier
1699743781
Registry record updated Mar 31, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1126 Issued in NC
Practice address
135 S Sharon Amity Rd Ste 100
Charlotte, NC 28211-3870
Phone
(704) 365-0555
Fax
(704) 367-8120
NPI assigned
Mar 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1126 NC Primary

Addresses

Primary practice location

135 S Sharon Amity Rd Ste 100
Charlotte, NC 28211-3870

Mailing address

PO Box 60160
Charlotte, NC 28260-0160
Phone (704) 365-0555

Other practice location 1

6035 Fairview Rd
Charlotte, NC 28210-3256
Phone (704) 295-3000

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
I20091228000386 NC Practitioner - Optometry 6709926660 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1126NCMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Horizon Eye Care, PA Optometrist CurrentSince Mar 15, 2019 Accepting new patients
Horizon Eye Care PA Optometrist Past Accepting new patients

Locations

135 S Sharon Amity Rd
Ste 100
Charlotte, NC 28211
Phone (704) 365-0555

11010 David Taylor Dr
Charlotte, NC 28262
Phone (704) 717-0058

10520 Park Rd
Charlotte, NC 28210
Phone (704) 541-6127

15419 Hodges Cir
Ste 100
Huntersville, NC 28078
Phone (704) 892-1000

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1142294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648684800000",
    "number": "1699743781",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60160",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282600160",
            "telephone_number": "704-365-0555",
            "fax_number": "704-367-8122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "135 S SHARON AMITY RD STE 100",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282113870",
            "telephone_number": "704-365-0555",
            "fax_number": "704-367-8120"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6035 Fairview Rd",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282103256",
            "country_code": "US",
            "telephone_number": "704-295-3000",
            "fax_number": "704-295-3468",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SIKES",
        "first_name": "MARK",
        "middle_name": "MOSELEY",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-14",
        "last_updated": "2022-03-31",
        "certification_date": "2022-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NC",
            "license": "1126",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.