Individual provider Active NPI

Dennis Lloyd Michels, OD

  • Optometrist
  • Kinston, NC
National Provider Identifier
1982783064
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
839 Issued in NC
Practice address
1007 W Vernon Ave
Kinston, NC 28501-3613
Phone
(252) 523-2020
Fax
(252) 522-4212
NPI assigned
Nov 2, 2006
Last updated
Mar 7, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 839 NC Primary

Addresses

Primary practice location

1007 W Vernon Ave
Kinston, NC 28501-3613

Mailing address

1007 W Vernon Ave
Kinston, NC 28501-3613
Phone (252) 523-2020

Other identifiers 1

IdentifierTypeStateIssuer
8902008MedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111205000929 NC Practitioner - Optometry 9537143151 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
839NCMDNutrition Chiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Myeyedr Optometry of North Carolina, PLLC Optometrist Current Accepting new patients
Myeyedr Optometry of North Carolina, PLLC Optometrist CurrentSince Jan 23, 2019 Accepting new patients
Myeyedr Optometry of North Carolina, PLLC Optometrist CurrentSince Jan 23, 2019 Accepting new patients

Locations

1960 Randolph Rd
Charlotte, NC 28207
Phone (704) 372-5332

1007 W Vernon Ave
Kinston, NC 28501
Phone (252) 523-2020

1950 Old Gallows Rd
Ste 520
Vienna, VA 22182

8614 Westwood Center Dr
Fl 9
Vienna, VA 22182

Organizations & group practices 3

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": "1162425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1982783064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1007 W VERNON AVE",
            "city": "KINSTON",
            "state": "NC",
            "postal_code": "285013613",
            "telephone_number": "252-523-2020",
            "fax_number": "252-522-4212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1007 W VERNON AVE",
            "city": "KINSTON",
            "state": "NC",
            "postal_code": "285013613",
            "telephone_number": "252-523-2020",
            "fax_number": "252-522-4212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MICHELS",
        "first_name": "DENNIS",
        "middle_name": "LLOYD",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-02",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NC",
            "license": "839",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8902008",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kinston, NC

Sources for this page

Verify at the official NPI Registry.