DR. KIMBERLY MARK DOUGLAS (NPI# 1942533153) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1942533153 |
| Entity Type | Individual |
| Full Name | DR. KIMBERLY MARK DOUGLAS |
| Credential | O.D. |
| Practice Address |
15640 Don Lochman Ln Ste C Charlotte NC 28277-4442 |
| Practice Telephone | 7049435110 |
| Practice Fax Number | 7049434449 |
| Mailing Telephone | 7049435110 |
| Mailing Fax Number | 7049434449 |
| Enumeration Date | 2009-09-08 |
| Last Update Date | 2019-07-16 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 152W00000X | Optometrist | 2257 | NC | Eye and Vision Services Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | DEA | MM2643559 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 11030 Golf Links Dr Ste 204, Charlotte, NC 282778047 | 7049435110 | 7049434449 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154448561 | Kimberly Brooke Douglas | Case Manager/Care Coordinator | 90 North Thirty First, Clinton, OK 73601 | 2007-03-23 |
| 1609941962 | Kimberly Marie Douglas | Speech-Language Pathologist | 1625 W Geronimo St, Chandler, AZ 85224-5616 | 2006-11-22 |
| 1609387463 | Kimberly Candece Douglas | Registered Nurse | 175 Gwinnett Dr, Lawrenceville, GA 30046-8444 | 2017-10-19 |
| 1558711077 | Kimberly Douglas | Counselor | 110 Maple St, Springfield, MA 01105-1864 | 2016-06-15 |
| 1508268962 | Kimberly Douglas | Registered Nurse | 1412 Us Highway 45 N, Eldorado, IL 62930-3766 | 2014-09-17 |
| 1932406659 | Kimberly Ann Douglas | Counselor | 1450 S Lapeer Rd, Oxford, MI 48371-6108 | 2011-02-15 |
| 1578786315 | Kimberly Douglas | Counselor | 8210 S Bright Rd, French Camp, CA 95231-9759 | 2007-04-10 |
| 1619017670 | Kimberly A Douglas | Pediatrics | 27800 Medical Center Rd, Suite 138, Mission Viejo, CA 92691-6410 | 2007-02-07 |
| 1770675738 | Kimberly Marie Douglas | Family Medicine | 436 5th & Ted Stevens Way, Kotzebue, AK 99752-0043 | 2006-09-28 |
| Street Address |
15640 DON LOCHMAN LN STE C |
| City | CHARLOTTE |
| State | NC |
| Zip Code | 28277-4442 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639623853 | Amanda Rickher | Optometrist | 15640 Don Lochman Ln Ste C, Charlotte, NC 28277-4442 | 2016-08-04 |
| 1073963112 | Stefanos Kotsokalis | Optometrist | 15640 Don Lochman Ln Ste C, Charlotte, NC 28277-4442 | 2016-06-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255949731 | New Life Peer Support and Coaching LLC | Clinic/Center | 3450 Toringdon Way, Suite 200, Charlotte, NC 28277 | 2020-07-21 |
| 1083256762 | Speak Life Counseling Services, Pllc | Counselor | 16147 Lacaster Hwy, Suite 110, Charlotte, NC 28277 | 2019-10-14 |
| 1275010019 | Jigneshkumar R Mistry | Pharmacist | 11805 Allforth Ln Apt 2105, Charlotte, NC 28277 | 2018-07-24 |
| 1255825410 | Novant Medical Group Inc. | Family Medicine | 15033 Balloncroft Parkway, Suite 200, Charlotte, NC 28277 | 2018-06-20 |
| 1447752316 | Harris Teeter LLC | Durable Medical Equipment & Medical Supplies | 11135 Golf Links Dr, Charlotte, NC 28277 | 2018-03-06 |
| 1932607595 | Charlotte Proactive Md PC | Clinic/Center | 11220 Golf Links Drive North, Charlotte, NC 28277 | 2018-01-30 |
| 1003331521 | Accela Spine and Pain, Pllc | Anesthesiology | 10120 Ivey Chase Lane, Apt 617, Charlotte, NC 28277 | 2017-08-04 |
| 1265961619 | Dominicka Whitaker | Counselor | 12365 Bluestem Ln., Charlotte, NC 28277 | 2017-06-08 |
| 1083143408 | Monika D Hayes | Counselor | 11330 Snapfinger Drive, Charlotte, NC 28277 | 2017-06-08 |
| 1225582984 | Danielle Mcdaniel | Occupational Therapist | 5113 Piper Station Dr Ste 103, Charlotte, NC 28277 | 2016-08-11 |
| Find all providers in zip 28277 | ||||
| Taxonomy Code | 152W00000X |
| Grouping | Eye and Vision Services Providers |
| Classification | Optometrist |
| Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system. |
| Notes: Source: American Optometric Association (AOA), approved by the AOA’s Board of Trustees, June 21, 2005. [7/1/2006: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962026534 | Francis Xavier Parr IIi | Optometrist | 7711 Arboretum Dr Apt 204, Charlotte, NC 28270-0016 | 2020-05-29 |
| 1992353825 | National Vision Inc | Optometrist | 14141 Steele Creek Rd Ste 400, Charlotte, NC 28273-4231 | 2019-09-04 |
| 1710535778 | Spencer Elise Moore | Optometrist | 100 N Tryon St Ste 280, Charlotte, NC 28202-4004 | 2019-09-03 |
| 1134773534 | Shannon Kirchmer | Optometrist | 4407 Mountain Cove Dr, Charlotte, NC 28216-7787 | 2019-07-25 |
| 1295387637 | Excel Eyecare Od Pa | Optometrist | 14154 Steele Creek Rd, Ste 200, Charlotte, NC 28273 | 2019-07-16 |
| 1679042741 | Sapounas Optometry Services, LLC | Optometrist | 4704 South Blvd Ste A, Charlotte, NC 28217-2745 | 2018-11-19 |
| 1376012534 | Jannifer Shin | Optometrist | 7615 Colony Rd Ste 105, Charlotte, NC 28226-5018 | 2018-11-17 |
| 1265927040 | Ryan Wirkus | Optometrist | 7808 S Tryon St Ste D, Charlotte, NC 28273-4299 | 2018-06-25 |
| 1427570639 | Caroline Kaleel Fogleman | Optometrist | 1710 Kenilworth Ave Ste 210, Charlotte, NC 28203 | 2017-07-10 |
| 1629522883 | Yesha Gami | Optometrist | 3506 W Tyvola Rd Fl 3, Charlotte, NC 28208-7201 | 2016-08-05 |
| Find all providers in CHARLOTTE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.