NPIMap

Organization Active NPI

Cabarrus Eye Center PA

  • Ophthalmology Physician
  • Concord, NC
National Provider Identifier
1922063304
Registry record updated Mar 18, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
39721 Issued in NC
Legal business name
CABARRUS EYE CENTER PA
Practice address
201 Lephillip Court NE
Concord, NC 28025-2900
Phone
(704) 782-1127
Fax
(704) 782-1207
NPI assigned
Apr 19, 2006
Last updated
Mar 18, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2008

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

Authorized official

Name
Dr. Kurt K. Lark, M. D.NPI 1497748396
Title
President
Phone
(704) 782-1127

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 39721 NC Primary

Addresses

Primary practice location

201 Lephillip Court NE
Concord, NC 28025-2900

Mailing address

201 Lephillip Court NE
Concord, NC 28025-2900
Phone (704) 782-1127

Other identifiers 3

IdentifierTypeStateIssuer
8901147MedicaidNC
01147OtherNCBLUE CROSS BLUE SHIELD
CA3344OtherNCMEDICARE RAILROAD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20050820000117 NC Part B Supplier - Clinic/Group Practice 5991735706 Receives reassigned benefits from 12 practitioners
Practice locations: Concord, NC
O20100930025047 NC DME Supplier - Physician - OptometristDME Supplier - Optician 5991735706 Practice locations: Concord, NC

National Provider Directory

National Provider Directory
Tax ID family
Cabarrus Optical Dept3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Locations

201 Le Phillip Ct NE
Concord, NC 28025
Phone (704) 782-1127

1714 Dale Earnhardt Blvd
Kannapolis, NC 28083
Phone (704) 933-1206

Practitioners & affiliated clinicians

Practitioners 16

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 16

NPI Registry JSON

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

{
    "created_epoch": "1145404800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1205798400000",
    "number": "1922063304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 LEPHILLIP COURT NE",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280252900",
            "telephone_number": "704-782-1127",
            "fax_number": "704-782-1207"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 LEPHILLIP COURT NE",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280252900",
            "telephone_number": "704-782-1127",
            "fax_number": "704-782-1207"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CABARRUS EYE CENTER PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-19",
        "last_updated": "2008-03-18",
        "status": "A",
        "authorized_official_last_name": "LARK",
        "authorized_official_first_name": "KURT",
        "authorized_official_middle_name": "K.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "704-782-1127",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M. D."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NC",
            "license": "39721",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8901147",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "01147",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "CA3344",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Concord, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2008; 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.