Individual provider Active NPI

Megan Christine Boughman, OD

  • Optometrist
  • Gastonia, NC
National Provider Identifier
1871089714
Registry record updated Sep 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2520 Issued in NC
Practice address
860 Summit Crossing PL Ste 110
Gastonia, NC 28054-2217
Phone
(704) 865-3937
Fax
(704) 865-8851
NPI assigned
Jul 3, 2018
Last updated
Sep 19, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2520 NC Primary
Optometrist 152W00000X 2077 SC

Addresses

Primary practice location

860 Summit Crossing PL Ste 110
Gastonia, NC 28054-2217

Mailing address

1950 Old Gallows Rd Ste 520
Vienna, VA 22182-3970
Phone (703) 847-8899

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
I20181109002045 NC Practitioner - Optometry 1658625660 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Advanced Family Eye Care - DRS of Optometry PLLCGroup PAC ID 6204733033, 7 clinicians

Practice addresses (Care Compare)

7547 Waterside Loop Rd
Denver, NC 28037-7677
Phone (704) 822-9920

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery24

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2520NCMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Myeyedr Optometry of North Carolina, PLLC Optometrist Current Accepting new patients
Myeyedr Optometry of North Carolina, PLLC Optometrist CurrentSince Sep 3, 2018 Accepting new patients
Advanced Family Eye Care - DRS of Optometry PLLC Optometrist CurrentSince May 26, 2022 Accepting new patients
Myeyedr Optometry of North Carolina, PLLC Optometrist CurrentSince Sep 3, 2018 Accepting new patients
Myeyedr Optometry of North Carolina, PLLC Optometrist Past Accepting new patients

Locations

1960 Randolph Rd
Charlotte, NC 28207
Phone (704) 372-5332

5330 South Blvd
#B
Charlotte, NC 28217
Phone (704) 523-7877

7547 Waterside Loop Rd
Denver, NC 28037
Phone (704) 822-9920

7547 Waterside Loop Rd
Ste A
Denver, NC 28037
Phone (704) 822-9920

860 Summit Crossing Pl
Ste 110
Gastonia, NC 28054
Phone (704) 865-3937

1950 Old Gallows Rd
Ste 520
Vienna, VA 22182

8614 Westwood Center Dr
Fl 9
Vienna, VA 22182

Interoperability endpoints

  • Direct secure messaging: megan.boughman@uprisedirect.com

Organizations & group practices 5

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": "1530576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537315200000",
    "number": "1871089714",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1950 OLD GALLOWS RD STE 520",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221823970",
            "telephone_number": "703-847-8899",
            "fax_number": "866-795-4020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "860 SUMMIT CROSSING PL STE 110",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280542217",
            "telephone_number": "704-865-3937",
            "fax_number": "704-865-8851"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOUGHMAN",
        "first_name": "MEGAN",
        "middle_name": "CHRISTINE",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-03",
        "last_updated": "2018-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NC",
            "license": "2520",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "SC",
            "license": "2077",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gastonia, NC

Sources for this page

Verify at the official NPI Registry.