Active NPI
James J Bedrick, M.D.
- Ophthalmology Physician
- Charlotte, NC
National Provider Identifier
1942279138
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ophthalmology Physician
- License
- 26082
- Practice address
- 2015 Randolph Rd
Suite 108
Charlotte, NC 28207-1200 - Phone
- (704) 334-2020
- Fax
- (704) 334-2020
- NPI assigned
- Mar 17, 2006
- Last updated
- Dec 31, 2012
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ophthalmology Physician | 207W00000X | 26082 | NC | Primary |
| Ophthalmology Physician | 207W00000X | 14216 | SC |
Addresses
Primary practice location
2015 Randolph Rd
Suite 108
Charlotte, NC 28207-1200
Mailing address
2025 Delpond LN
Charlotte, NC 28226-6467
Phone (704) 334-2020
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| N26082 | Medicaid | SC | |
| 8914330 | 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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 14216 | SC | MD | Ophthalmology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mecklenburg Eye Associates PA | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Ophthalmology Physician
- Charlotte, NC
- NPI 1578527040
-
- Eyewear Supplier
- Charlotte, NC
- NPI 1972751964
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1142553600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1356912000000",
"number": "1942279138",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2025 DELPOND LN",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282266467",
"telephone_number": "704-334-2020",
"fax_number": "704-334-6175"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2015 RANDOLPH RD",
"address_2": "SUITE 108",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282071200",
"telephone_number": "704-334-2020",
"fax_number": "704-334-2020"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BEDRICK",
"first_name": "JAMES",
"middle_name": "J",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-03-17",
"last_updated": "2012-12-31",
"status": "A"
},
"taxonomies": [
{
"code": "207W00000X",
"taxonomy_group": "",
"desc": "Ophthalmology",
"state": "NC",
"license": "26082",
"primary": true
},
{
"code": "207W00000X",
"taxonomy_group": "",
"desc": "Ophthalmology",
"state": "SC",
"license": "14216",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "N26082",
"state": "SC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8914330",
"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 Dec 31, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.