Active NPI
Glenn Scott Matheny, O.D.
- Optometrist
- Greensboro, NC
National Provider Identifier
1700900701
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 850
- Practice address
- 3738 Battleground Ave
Greensboro, NC 27410-2344 - Phone
- (336) 282-5101
- NPI assigned
- Mar 17, 2007
- Last updated
- Jul 8, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 850 | NC | Primary |
Addresses
Primary practice location
3738 Battleground Ave
Greensboro, NC 27410-2344
Mailing address
PO Box 790
Pisgah Forest, NC 28768-0790
Phone (828) 884-9894
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 48391 | Other | NC | DAVIS |
| 8909547 | Medicaid | NC | |
| 661290 | Other | NC | UNITED HEALTH CARE |
| 09547 | Other | NC | BLUE CROSS BLUE SHIELD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 850 | NC | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Looking Glass Eye Center PA | Optometrist | Past | Accepting new patients |
| Looking Glass Eye Center P a | Optometrist | Past | Accepting new patients |
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, 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": "1174089600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1700900701",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 790",
"city": "PISGAH FOREST",
"state": "NC",
"postal_code": "287680790",
"telephone_number": "828-884-9894"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3738 BATTLEGROUND AVE",
"city": "GREENSBORO",
"state": "NC",
"postal_code": "274102344",
"telephone_number": "336-282-5101"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MATHENY",
"first_name": "GLENN",
"middle_name": "SCOTT",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-03-17",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "NC",
"license": "850",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DAVIS",
"identifier": "48391",
"state": "NC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8909547",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HEALTH CARE",
"identifier": "661290",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "09547",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Greensboro, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.