Lisa Carol Dudley, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

1924 Issued in NC

Practice address

3061 N Sharon Amity Rd
Charlotte, NC 28205-6600

Phone

(704) 567-6755

Fax

(704) 567-0238

NPI assigned

Jul 26, 2006

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

University of Houston - College of Optometry, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

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 and National Provider Directory roles.

• Charlotte Optometry Center, O.D., PLLC

  • Optometrist
  • Charlotte, NC
  • NPI 1558782821
  Medicare reassignment NPD Authorized official
• Charlotte Optometry Group PA

  • Optometrist
  • Charlotte, NC
  • NPI 1295829380
  NPD (past)

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

{
    "created_epoch": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1891719845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3515 SELWYN AVE",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282093501",
            "telephone_number": "704-521-2719",
            "fax_number": "704-567-0238"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3061 N SHARON AMITY RD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282056600",
            "telephone_number": "704-567-6755",
            "fax_number": "704-567-0238"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUDLEY",
        "first_name": "LISA",
        "middle_name": "CAROL",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NC",
            "license": "1924",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89093R5",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Allison Dudley, M.D.
• Alyssa Dudley, MS CCC-SLP
• Eric C. Dudley, O.D.
• Kim Dudley, CMP
• Leigh Ellen Laster Dudley, MS, RDN, LDN
• Shirley C. Dudley, LPC
• Nicole Dudney, DPT
• Gregory John Duellman, D.O.
• Sarah Louise Duensing, PA
• Kelsey Dufault, M.S., OTR/L

• 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 Jul 8, 2007; 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.