Individual provider Active NPI

Michael Scott, O.D.

  • Optometrist
  • Gastonia, NC
National Provider Identifier
1740260686
Registry record updated Mar 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1142 Issued in NC
Practice address
860 Summit Crossing PL Ste 110
Gastonia, NC 28054-2217
Phone
(704) 865-3937
NPI assigned
Jan 18, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 14, 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 1142 NC Primary

Addresses

Primary practice location

860 Summit Crossing PL Ste 110
Gastonia, NC 28054-2217

Mailing address

1950 Old Gallows Rd
Suite 520
Vienna, VA 22182-3990
Phone (703) 847-8899

Other identifiers 1

IdentifierTypeStateIssuer
8909816MedicaidNC

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
I20080731000649 NC Practitioner - Optometry 0547334039 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pacific University - College of Optometry, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Myeyedr Optometry of North Carolina PLLCGroup PAC ID 6608019096, 167 clinicians

Practice addresses (Care Compare)

1960 Randolph Rd
Charlotte, NC 28207-1129
Phone (704) 372-5332

860 Summit Crossing PL
Suite 110
Gastonia, NC 28054-2217
Phone (704) 865-3937

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1142NCMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Myeyedr Optometry of North Carolina, PLLC Optometrist CurrentSince Aug 29, 2014 Accepting new patients
Myeyedr Optometry of North Carolina, PLLC Optometrist CurrentSince Aug 29, 2014 Accepting new patients
Myeyedr Optometry of North Carolina, PLLC Optometrist Current Accepting new patients
Myeyedr Optometry of North Carolina Optometrist Past Accepting new patients

Locations

7808 S Tryon St
Ste D
Charlotte, NC 28273
Phone (704) 522-8000

1960 Randolph Rd
Charlotte, NC 28207
Phone (704) 372-5332

860 Summit Crossing Pl
Ste 110
Gastonia, NC 28054
Phone (704) 865-3937

1302 E Garrison Blvd
Gastonia, NC 28054
Phone (704) 295-0001

1950 Old Gallows Rd
Ste 520
Vienna, VA 22182

8614 Westwood Center Dr
Fl 9
Vienna, VA 22182

Organizations & group practices 4

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": "1137542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647216000000",
    "number": "1740260686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1950 OLD GALLOWS RD",
            "address_2": "SUITE 520",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221823990",
            "telephone_number": "703-847-8899",
            "fax_number": "703-991-0514"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "860 SUMMIT CROSSING PL STE 110",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280542217",
            "telephone_number": "704-865-3937"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCOTT",
        "first_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-18",
        "last_updated": "2022-03-14",
        "certification_date": "2022-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NC",
            "license": "1142",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8909816",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gastonia, NC

Sources for this page

Verify at the official NPI Registry.