Poole Eyecare PA

Primary specialty

OptometristTaxonomy code 152W00000X

License

NC1109 Issued in NC

Legal business name

POOLE EYECARE PA

Practice address

808 W King St
Kings MTN, NC 28086-2748

Phone

(704) 739-5581

Fax

(704) 739-0000

NPI assigned

May 4, 2006

Last updated

Feb 14, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Benjamin C Poole, ODNPI 1871550897

Title

President

Phone

(704) 739-5581

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NC2 enrollments

Enrollment records 2

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Poole Eyecare PA

  • Optometrist
  • Clover, SC
  • NPI 1699733501

  8729135603

  Same PAC ID

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Locations

Practitioners 2

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.

• Benjamin C Poole, OD

  • Optometrist
  • Clover, SC
  • NPI 1871550897

  NC

  Medicare reassignment NPD Authorized official
• Zachary Barton Poole, MD

  • Ophthalmology Physician
  • Clover, SC
  • NPI 1790246585

  NC

  Medicare reassignment NPD

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

{
    "created_epoch": "1146700800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1707868800000",
    "number": "1962450098",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "808 W KING ST",
            "city": "KINGS MOUNTAIN",
            "state": "NC",
            "postal_code": "280862748",
            "telephone_number": "704-739-5581",
            "fax_number": "704-739-0000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "808 W KING ST",
            "city": "KINGS MTN",
            "state": "NC",
            "postal_code": "280862748",
            "telephone_number": "704-739-5581",
            "fax_number": "704-739-0000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POOLE EYECARE PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-04",
        "last_updated": "2024-02-14",
        "certification_date": "2024-02-14",
        "status": "A",
        "authorized_official_last_name": "POOLE",
        "authorized_official_first_name": "BENJAMIN",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "704-739-5581",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NC",
            "license": "NC1109",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89-09655",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• David R McDaniel OD PA
• Focus Point Inc
• Kmeg Resource Corp PA
• Dewey Truman Matherly, LCSW
• Agnes Ewo Mihngha
• Stephanie Jones Ramsey, FNP-C
• Self-Determination LLC

• Optometrist in Kings MTN, NC
• Providers in Kings MTN, NC by specialty
• Optometrist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.