Organization Active NPI

Dr. Gary S. Miller & Associates, Optometrists, PA

  • Optometrist
  • Charlotte, NC
National Provider Identifier
1962672675
Registry record updated Oct 17, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1307 Issued in NC
Legal business name
DR. GARY S. MILLER & ASSOCIATES, OPTOMETRISTS, PA
Practice address
6801 Northlake Mall Dr
Northlake Mall #253
Charlotte, NC 28216-0711
Phone
(704) 509-4490
Fax
(704) 509-4491
NPI assigned
Mar 10, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2008

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

Authorized official

Name
Dr. Gary Stephen Miller, O.D.
Title
President
Phone
(704) 509-4490

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 1307 NC Primary

Addresses

Primary practice location

6801 Northlake Mall Dr
Northlake Mall #253
Charlotte, NC 28216-0711

Mailing address

6801 Northlake Mall Dr
Northlake Mall #253
Charlotte, NC 28216-0711
Phone (704) 509-4490

National Provider Directory

National Provider Directory

Locations

5657 Central Ave
Eastland Mall
Charlotte, NC 28212
Phone (704) 563-7655

1480 Concord Pkwy N
Ste 301
Concord, NC 28025
Phone (704) 721-5522

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1205107200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1224201600000",
    "number": "1962672675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6801 NORTHLAKE MALL DR",
            "address_2": "NORTHLAKE MALL #253",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282160711",
            "telephone_number": "704-509-4490",
            "fax_number": "704-509-4491"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6801 NORTHLAKE MALL DR",
            "address_2": "NORTHLAKE MALL #253",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282160711",
            "telephone_number": "704-509-4490",
            "fax_number": "704-509-4491"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. GARY S. MILLER & ASSOCIATES, OPTOMETRISTS, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-10",
        "last_updated": "2008-10-17",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "GARY",
        "authorized_official_middle_name": "STEPHEN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "704-509-4490",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "NC",
            "license": "1307",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Oct 17, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.