Active NPI
George Anderson Overman, OPTICIAN
- Optician
- Elizabeth City, NC
National Provider Identifier
1992859847
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optician
- License
- 615
- Practice address
- 1125 N Road St
Elizabeth City, NC 27909-3334 - Phone
- (252) 331-7922
- Fax
- (252) 331-2111
- NPI assigned
- Jan 22, 2007
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optician | 156FX1800X | 615 | NC | Primary |
Addresses
Primary practice location
1125 N Road St
Elizabeth City, NC 27909-3334
Mailing address
1125 N Road St
Elizabeth City, NC 27909-3334
Phone (252) 331-7922
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8801974 | 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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 615 | NC | MD | Audiologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| George'S Optical Shop | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Durable Medical Equipment & Medical Supplies
- Elizabeth City, NC
- NPI 1093993081
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169424000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1992859847",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1125 N ROAD ST",
"city": "ELIZABETH CITY",
"state": "NC",
"postal_code": "279093334",
"telephone_number": "252-331-7922",
"fax_number": "252-331-2111"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1125 N ROAD ST",
"city": "ELIZABETH CITY",
"state": "NC",
"postal_code": "279093334",
"telephone_number": "252-331-7922",
"fax_number": "252-331-2111"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OVERMAN",
"first_name": "GEORGE",
"middle_name": "ANDERSON",
"name_prefix": "Mr.",
"credential": "OPTICIAN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-01-22",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "156FX1800X",
"taxonomy_group": "",
"desc": "Technician/Technologist, Optician",
"state": "NC",
"license": "615",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8801974",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Elizabeth City, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.