Active NPI
Grady Bowens
- Optician
- Charlotte, NC
National Provider Identifier
1912190372
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optician
- License
- 1336
- Practice address
- 3211 Eastway Dr Ste 13
Charlotte, NC 28205-6679 - Phone
- (704) 568-6760
- Fax
- (704) 568-7059
- NPI assigned
- Aug 20, 2007
- Last updated
- Sep 6, 2026
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optician | 156FX1800X | 1336 | NC | Primary |
Addresses
Primary practice location
3211 Eastway Dr Ste 13
Charlotte, NC 28205-6679
Mailing address
3211 Eastway Dr Ste 13
Charlotte, NC 28205-6679
Phone (704) 568-6760
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8802016 | Medicaid | NC |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1336 | NC | MD | Addiction (Substance Use Disorder) Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| One Way Eye Care | Optician | Past | Accepting new patients |
Organizations & group practices 1
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": "1187568000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1788652800000",
"number": "1912190372",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3211 EASTWAY DR STE 13",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282056679",
"telephone_number": "704-568-6760",
"fax_number": "704-568-7059"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3211 EASTWAY DR STE 13",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282056679",
"telephone_number": "704-568-6760",
"fax_number": "704-568-7059"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOWENS",
"first_name": "GRADY",
"name_prefix": "Mr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-08-20",
"last_updated": "2026-09-06",
"status": "A"
},
"taxonomies": [
{
"code": "156FX1800X",
"taxonomy_group": "",
"desc": "Technician/Technologist, Optician",
"state": "NC",
"license": "1336",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8802016",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}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 Sep 6, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.