Michelle Kathleen Mumford, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

2225 Issued in NC

Practice address

1710 Kenilworth Ave Ste 210
Charlotte, NC 28203-0008

Phone

(704) 348-1500

NPI assigned

Jan 14, 2009

Sex

Female

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 1

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

Southern College of Optometry, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Innovative Eye Care OD PLLCGroup PAC ID 0042482515, 3 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.

• Innovative Eye Care OD PLLC

  • Optometrist
  • Charlotte, NC
  • NPI 1114201936
  Medicare reassignment Care Compare group NPD Authorized official
• Dr Irwin Azman & Dr Thomas Azman Ods PA

  dba Azman Eye Care Specialists

  • Ophthalmology Physician
  • Baltimore, MD
  • NPI 1891856357

  Optometrist

  NPD (past)

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

{
    "created_epoch": "1231891200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633392000000",
    "number": "1821235706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1710 KENILWORTH AVE",
            "address_2": "SUITE 210",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282035256",
            "telephone_number": "704-348-1500",
            "fax_number": "704-919-0289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1710 KENILWORTH AVE STE 210",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282030008",
            "telephone_number": "704-348-1500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUMFORD",
        "first_name": "MICHELLE",
        "middle_name": "KATHLEEN",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-01-14",
        "last_updated": "2021-10-05",
        "certification_date": "2021-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NC",
            "license": "2225",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "NC2110A342",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dane Mullis
• Loveleen Sonia Multani, MSW, LCSW-A
• Multidimensional Healing Collective LLC
• Hannah Noel Mulvey, PA
• Paul J Mulvihill, DC
• Tishana Shalice Mumford, MA, CCC-SLP
• Zakkiyya Nasreen Mumin, NP
• Nicholas Frank Munaretto, MD
• Girish Somashekhar Munavalli, M.D.
• Lisa Munday, LCSWA

• Optometrist in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Optometrist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2021; 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.