NPIMap

Organization Active NPI

Corte and Wruble, OD, PLLC

Doing business as Northlake Eye

  • Optometrist
  • Charlotte, NC
National Provider Identifier
1821529249
Registry record updated May 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2165 Issued in NC
Legal business name
CORTE AND WRUBLE, OD, PLLC
Doing business as
Northlake Eye
Practice address
6801 Northlake Mall Dr
Charlotte, NC 28216-0711
Phone
(704) 509-4490
NPI assigned
Mar 27, 2017
Last updated
May 13, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 13, 2020

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

Authorized official

Name
Rachael Wruble
Title
Optometrist/Owner
Phone
(704) 860-9944

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2165 NC Primary

Addresses

Primary practice location

6801 Northlake Mall Dr
Charlotte, NC 28216-0711

Mailing address

PO Box 1330
Belmont, NC 28012-1330

Other identifiers 1

IdentifierTypeStateIssuer
AO8892OtherNCEYEMED

Other names 1

  • Northlake Eye Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170607000704 NC Part B Supplier - Clinic/Group Practice 5294002689 Receives reassigned benefits from 25 practitioners
Practice locations: Asheville, NC; Charlotte, NC; Concord, NC

National Provider Directory

National Provider Directory
Tax ID family
Corte and Wruble OD PLLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

3 S Tunnel Rd
Ste 187
Asheville, NC 28805
Phone (828) 299-0055

6801 Northlake Mall Dr
Charlotte, NC 28216
Phone (704) 509-4490

Practitioners & affiliated clinicians

Practitioners 30

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 30

NPI Registry JSON

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

{
    "created_epoch": "1490572800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1589328000000",
    "number": "1821529249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1330",
            "city": "BELMONT",
            "state": "NC",
            "postal_code": "280121330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6801 NORTHLAKE MALL DR",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282160711",
            "telephone_number": "704-509-4490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORTE AND WRUBLE, OD, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-27",
        "last_updated": "2020-05-13",
        "certification_date": "2020-05-13",
        "status": "A",
        "authorized_official_last_name": "WRUBLE",
        "authorized_official_first_name": "RACHAEL",
        "authorized_official_title_or_position": "OPTOMETRIST/OWNER",
        "authorized_official_telephone_number": "704-860-9944"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NC",
            "license": "2165",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EYEMED",
            "identifier": "AO8892",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Northlake Eye",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Charlotte, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.