Active NPI
Katherine Edwards Milam, LDO LICENSED DISPENS
- Optician
- Black Mountain, NC
National Provider Identifier
1821117482
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optician
- License
- 836
- Practice address
- 145A Old Hwy 70 East
Black Mountain, NC 28711 - Phone
- (828) 669-5775
- Fax
- (828) 669-6024
- NPI assigned
- Mar 28, 2007
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Optician | 156FX1800X | 836 | NC | Primary |
Addresses
Primary practice location
145A Old Hwy 70 East
Black Mountain, NC 28711
Mailing address
145A Old Hwy 70 East
Black Mountain, NC 28711
Phone (828) 669-5775
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8802025 | Medicaid | NC |
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 836 | NC | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1175040000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1821117482",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "145A OLD HWY 70 EAST",
"city": "BLACK MOUNTAIN",
"state": "NC",
"postal_code": "28711",
"telephone_number": "828-669-5775",
"fax_number": "828-669-6024"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "145A OLD HWY 70 EAST",
"city": "BLACK MOUNTAIN",
"state": "NC",
"postal_code": "28711",
"telephone_number": "828-669-5775",
"fax_number": "828-669-6024"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MILAM",
"first_name": "KATHERINE",
"middle_name": "EDWARDS",
"credential": "LDO LICENSED DISPENS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-28",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "156FX1800X",
"taxonomy_group": "",
"desc": "Technician/Technologist, Optician",
"state": "NC",
"license": "836",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8802025",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Black Mountain, 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.