Individual provider Active NPI

Marvin Walker, OD

  • Optometrist
  • Spruce Pine, NC
National Provider Identifier
1811008451
Registry record updated Feb 7, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1129 Issued in NC
Practice address
54 Hill St
Spruce Pine, NC 28777-8923
Phone
(828) 765-2020
Fax
(828) 765-2451
NPI assigned
Aug 31, 2006
Last updated
Feb 7, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1129 NC Primary

Addresses

Primary practice location

54 Hill St
Spruce Pine, NC 28777-8923

Mailing address

54 Hill St
Spruce Pine, NC 28777-8923
Phone (828) 765-2020

Other identifiers 4

IdentifierTypeStateIssuer
2270853OtherNCUNITED HEALTH CARE
8909946MedicaidNC
09946OtherNCBLUE CROSS/BLUE SHIELD
246416COtherNCRAILROAD MEDICARE

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
I20110427000503 NC Practitioner - Optometry 2062546104 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University Alabama Birmingham - School of Optometry, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Appalachian Eye Associates OdpaGroup PAC ID 4486788528, 2 clinicians

Practice addresses (Care Compare)

54 Hill St
Spruce Pine, NC 28777-8923
Phone (828) 765-2020

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery49

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1129NCMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Appalachian Eye Associates Odpa Optometrist CurrentSince May 10, 1997 Accepting new patients

Locations

54 Hill St
Spruce Pine, NC 28777
Phone (828) 765-2020

Interoperability endpoints

  • Direct secure messaging: mew@appalachianeye.emadirect.md

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, 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": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1202342400000",
    "number": "1811008451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "54 HILL ST",
            "city": "SPRUCE PINE",
            "state": "NC",
            "postal_code": "287778923",
            "telephone_number": "828-765-2020",
            "fax_number": "828-765-2451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "54 HILL ST",
            "city": "SPRUCE PINE",
            "state": "NC",
            "postal_code": "287778923",
            "telephone_number": "828-765-2020",
            "fax_number": "828-765-2451"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALKER",
        "first_name": "MARVIN",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2008-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NC",
            "license": "1129",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTH CARE",
            "identifier": "2270853",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8909946",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD",
            "identifier": "09946",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "246416C",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Spruce Pine, NC

Sources for this page

Verify at the official NPI Registry.