Individual provider Active NPI

Andrew L Williams, OD

  • Optometrist
  • Newland, NC
National Provider Identifier
1710072491
Registry record updated Apr 14, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
NC1404 Issued in NC
Practice address
681 Cranberry St
Newland, NC 28657-8801
Phone
(828) 733-2011
Fax
(828) 733-6177
NPI assigned
Oct 4, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 14, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X NC1404 NC Primary

Addresses

Primary practice location

681 Cranberry St
Newland, NC 28657-8801

Mailing address

681 Cranberry St
P.O. Box 880
Newland, NC 28657-8801
Phone (828) 733-2011

Other identifiers 3

IdentifierTypeStateIssuer
09143OtherNCBLUE CROSS/BLUE SHIELDS
22-71114OtherNCUNITED HEALTH CARE
890903JMedicaidNC

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
I20110413000885 NC Practitioner - Optometry 3971617192 Practice locations: Newland, NC

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pennsylvania College of Optometry, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

681 Cranberry St
Newland, NC 28657-0681
Phone (828) 733-2011

PO Box
Suite 880
Newland, NC 28657-0880

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
1404NCMDAddiction (Substance Use Disorder) Counselor
NC1404NCMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Shelby Eye Centers, P.a. Optometrist PastSince Aug 2, 1993 Accepting new patients

Organizations & group practices 1

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": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1302739200000",
    "number": "1710072491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "681 CRANBERRY ST",
            "address_2": "P.O. BOX 880",
            "city": "NEWLAND",
            "state": "NC",
            "postal_code": "286578801",
            "telephone_number": "828-733-2011",
            "fax_number": "828-733-6177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "681 CRANBERRY ST",
            "city": "NEWLAND",
            "state": "NC",
            "postal_code": "286578801",
            "telephone_number": "828-733-2011",
            "fax_number": "828-733-6177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "ANDREW",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-04",
        "last_updated": "2011-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NC",
            "license": "NC1404",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELDS",
            "identifier": "09143",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTH CARE",
            "identifier": "22-71114",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "890903J",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Newland, NC

Sources for this page

Verify at the official NPI Registry.