Charles Lamotte Clark, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

1749 Issued in NC

Practice address

4811 Fayetteville Road
Lumberton, NC 28358

Phone

(910) 739-3323

Fax

(910) 739-6489

NPI assigned

Nov 15, 2006

Last updated

Nov 2, 2012By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

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

Specialty

Optometry

Education

Pennsylvania College of Optometry, 1993

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Eyecarecenter OD PAGroup PAC ID 7315834462, 71 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Eyecarecenter OD PA

  • Optometrist
  • Cary, NC
  • NPI 1417973546
  Medicare reassignment Care Compare group NPD
• Eyecarecenter, O.D., P.a.

  dba EyeCare Center

  • Optometrist
  • Fayetteville, NC
  • NPI 1336876788
  NPD
• C.V. Sikes,Jr. & R.B. Gotschalk PTR

  dba Family Eye Care Optometry

  • Optometrist
  • Sanford, NC
  • NPI 1083768311
  NPD (past)

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

{
    "created_epoch": "1163548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1351814400000",
    "number": "1760555189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4811 FAYETTEVILLE ROAD",
            "city": "LUMBERTON",
            "state": "NC",
            "postal_code": "28358",
            "telephone_number": "910-739-3323",
            "fax_number": "910-739-6489"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4811 FAYETTEVILLE ROAD",
            "city": "LUMBERTON",
            "state": "NC",
            "postal_code": "28358",
            "telephone_number": "910-739-3323",
            "fax_number": "910-739-6489"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "CHARLES",
        "middle_name": "LAMOTTE",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-15",
        "last_updated": "2012-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NC",
            "license": "1749",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0923L",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "890923L",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "2238827",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Children's Health of Carolina, PA (Children's Health Lumberton)
• Chosen Health Care Services Inc
• Christa Assisted Living
• Leslie Christman
• Windy Dotson Christy, PA-C
• Cynthia Anne Clark, F.N.P.
• Megan G Clark, LCMHCA
• Vicki E Clark, NP
• Clear Hearing Solutions IV, LLC (Miracle Ear)
• Thomas Hilburn Cleveland Jr., DDS

• Optometrist in Lumberton, NC
• Providers in Lumberton, 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 2, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.