Angela Marie Fox-Putnam, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

1387 Issued in NC

Practice address

612 S Main St
Mount Holly, NC 28120-1653

Phone

(704) 822-0099

Fax

(704) 822-0077

NPI assigned

Jan 18, 2006

Last updated

Oct 16, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 5

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

Specialty

Optometry

Education

University of Houston - College of Optometry, 1990

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Myeyedr Optometry of North Carolina PLLCGroup PAC ID 6608019096, 167 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Myeyedr Optometry of North Carolina, PLLC

  dba MyEyeDr

  • Optometrist
  • Charlotte, NC
  • NPI 1023183563
  Medicare reassignment Care Compare group NPD
• Mount Holly Eye Clinic, OD, PA

  • Optometrist
  • Mount Holly, NC
  • NPI 1720261662
  NPD Authorized official
• Myeyedr Optometry of North Carolina PLLC

  dba MyEyeDr.

  • Optometrist
  • Gastonia, NC
  • NPI 1518373596
  NPD
• Myeyedr Optometry of North Carolina, PLLC

  • Optometrist
  • Monroe, NC
  • NPI 1407737182
  NPD
• Myeyedr Optometry of North Carolina

  dba MyEyeDr

  • Optometrist
  • Charlotte, NC
  • NPI 1700851045
  NPD (past)

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

{
    "created_epoch": "1137542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729036800000",
    "number": "1992785836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "612 SOUTH MAIN STREET",
            "city": "MOUNT HOLLY",
            "state": "NC",
            "postal_code": "281201653",
            "telephone_number": "704-822-0099",
            "fax_number": "704-822-0077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "612 S MAIN ST",
            "city": "MOUNT HOLLY",
            "state": "NC",
            "postal_code": "281201653",
            "telephone_number": "704-822-0099",
            "fax_number": "704-822-0077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOX-PUTNAM",
        "first_name": "ANGELA",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-01-18",
        "last_updated": "2024-10-16",
        "certification_date": "2024-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NC",
            "license": "1387",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "0928G",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DAVIS VISION",
            "identifier": "4622",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EYEMED",
            "identifier": "OP069",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SPECTERA",
            "identifier": "12304",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "890928G",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shelby King Fields, RN
• Kayla Michelle Fomin, OMT
• Ford Williams Family Therapy, LLC (Ford Williams Family Therapy)
• Fostering the Mind, PLLC
• Victoria Fowler, SLP
• Melissa Joan Francis, LPCA
• Johnathon Wyatt Friar, ATC, LAT
• Anna Elisabeth Frye
• Gaston Family Health Services, Inc. (Kintegra at Pinewood Elementary)
• Gaston Family Health Services, Inc. (Kintegra at Mt Holly Middle)

• Optometrist in Mount Holly, NC
• Providers in Mount Holly, NC by specialty
• Optometrist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.