Individual provider Active NPI

Lee James Carter, O.D.

  • Optometrist
  • Mountain Home, ID
National Provider Identifier
1891789368
Registry record updated Feb 4, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
ODP-100084 Issued in ID
Practice address
2745 American Legion Blvd
Mountain Home, ID 83647-3185
Phone
(208) 587-0974
Fax
(208) 587-0994
NPI assigned
Sep 9, 2005
Last updated
Feb 4, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X ODP-100084 ID Primary

Addresses

Primary practice location

2745 American Legion Blvd
Mountain Home, ID 83647-3185

Mailing address

2745 American Legion Blvd
Mountain Home, ID 83647-3185
Phone (208) 587-0974

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID
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
I20051206000318 ID Practitioner - Optometry 6608896980 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Ohio State University - College of Optometry, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emmett Eye Center, PLLCGroup PAC ID 9931367166, 2 clinicians

Practice addresses (Care Compare)

1108 S Washington Ave
Emmett, ID 83617-3535
Phone (208) 365-2020

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
ODP-100084IDMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Emmett Eye Center, PLLC Optometrist CurrentSince Nov 8, 2023 Accepting new patients
Idaho Eyelid & Facial Plastic Surgery , PLLC Optometrist PastSince Mar 1, 2000 Accepting new patients
Southern Idaho Vision Alliance,PLLC Optometrist Past Accepting new patients
Sparhawk Vision, CHTD Past Accepting new patients

Locations

1108 S Washington Ave
Emmett, ID 83617
Phone (208) 365-2020

Organizations & group practices 6

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": "1126224000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1359936000000",
    "number": "1891789368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2745 AMERICAN LEGION BLVD",
            "city": "MOUNTAIN HOME",
            "state": "ID",
            "postal_code": "836473185",
            "telephone_number": "208-587-0974",
            "fax_number": "208-587-0994"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2745 AMERICAN LEGION BLVD",
            "city": "MOUNTAIN HOME",
            "state": "ID",
            "postal_code": "836473185",
            "telephone_number": "208-587-0974",
            "fax_number": "208-587-0994"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARTER",
        "first_name": "LEE",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-09",
        "last_updated": "2013-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "ID",
            "license": "ODP-100084",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mountain Home, ID

Sources for this page

Verify at the official NPI Registry.