Charlotte Optometric Clinic, PA

Primary specialty

OptometristTaxonomy code 152W00000X

License

1393 Issued in NC

Legal business name

CHARLOTTE OPTOMETRIC CLINIC, PA

Practice address

9425 South Blvd Ste a
Charlotte, NC 28273-6900

Phone

(704) 341-7676

Fax

(704) 370-9751

NPI assigned

Nov 26, 2007

Last updated

Nov 21, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Masherrill Koonce, O.D.NPI 1881647147

Title

Optometrist

Phone

(704) 341-7676

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Locations

Practitioners 8

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.

• Masherrill F Koonce, O.D.

  • Optometrist
  • Charlotte, NC
  • NPI 1881647147
  Medicare reassignment Care Compare group NPD Authorized official
• Donnie Koonce, OD

  • Optometrist
  • Salisbury, NC
  • NPI 1558129817
  Medicare reassignment Care Compare group NPD
• Brittany Morris

  • Optometrist
  • Salisbury, NC
  • NPI 1912766460
  Medicare reassignment Care Compare group NPD
• Ania M Hamp, OD

  • Optometrist
  • Salisbury, NC
  • NPI 1912969049
  NPD (past)
• Robert Charles Hamp

  • Optometrist
  • Charlotte, NC
  • NPI 1760443188
  NPD (past)
• Michael James Johnson, O.D.

  • Optometrist
  • Charlotte, NC
  • NPI 1841391471
  NPD (past)
• Scott Louis Philippe, O.D.

  • Optometrist
  • Charlotte, NC
  • NPI 1376644906
  NPD (past)
• Heather C Smith, O.D.

  • Optometrist
  • Charlotte, NC
  • NPI 1750380796
  NPD (past)

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

{
    "created_epoch": "1196035200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1700524800000",
    "number": "1699956227",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9425 SOUTH BLVD STE A",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282736900",
            "telephone_number": "704-341-7676",
            "fax_number": "704-370-9751"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9425 SOUTH BLVD STE A",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282736900",
            "telephone_number": "704-341-7676",
            "fax_number": "704-370-9751"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHARLOTTE OPTOMETRIC CLINIC, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-26",
        "last_updated": "2023-11-21",
        "certification_date": "2023-11-21",
        "status": "A",
        "authorized_official_last_name": "KOONCE",
        "authorized_official_first_name": "MASHERRILL",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "704-341-7676",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "NC",
            "license": "1393",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "890920G",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5918202",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Charlotte One More Go Physical Therapy & Wellness LLC
• Charlotte One on One Physical Therapy
• Charlotte Opco Holdings, LLC (East Towne)
• Charlotte Operating Al, LLC (The Parc at Sharon Amity)
• Charlotte Operator LLC (Charlotte Health & Rehabilitation Center)
• Charlotte Optometry Center, O.D., PLLC
• Charlotte Optometry Group PA
• Charlotte Optometry Group PA
• Charlotte Orthodontics
• Charlotte Pain Associates PA

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2023; 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.