David R Daughtry Jr., OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

2220 Issued in NC

Practice address

801 E Center St
Lexington, NC 27292-4401

Phone

(336) 249-8901

Fax

(336) 248-2695

NPI assigned

Jun 22, 2011

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Southern College of Optometry, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Clark Optometric Center PAGroup PAC ID 6709911092, 45 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles (4 of 7)

Locations

Networks

• devoted network organization-84bf27aa-506a-49c4-8818-702cf5e8efb3
• devoted network organization-0f7f8d4f-1035-4992-8c02-dc86d12e700e
• devoted network organization-92131eb0-09f2-4173-a140-cf7b381f0cf1

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.

• Clark Optometric Center PA

  • Optometrist
  • Durham, NC
  • NPI 1588619217

  NC, Optometrist

  Medicare reassignment Care Compare group NPD
• Academy Eye Center Optometry, PA

  • Optometrist
  • Biscoe, NC
  • NPI 1396966602
  NPD (past)
• Academy Eye Center Optometry, PA

  • Optometrist
  • Randleman, NC
  • NPI 1609909555
  NPD (past)
• Amy V Harper, OD PLLC

  • Optometrist
  • Kernersville, NC
  • NPI 1669672309
  NPD (past)

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

{
    "created_epoch": "1308700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530057600000",
    "number": "1003102633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "504 E CENTER ST",
            "city": "LEXINGTON",
            "state": "NC",
            "postal_code": "272924112",
            "telephone_number": "336-249-8901",
            "fax_number": "336-248-2695"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 E CENTER ST",
            "city": "LEXINGTON",
            "state": "NC",
            "postal_code": "272924401",
            "telephone_number": "336-249-8901",
            "fax_number": "336-248-2695"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAUGHTRY",
        "first_name": "DAVID",
        "middle_name": "R",
        "name_suffix": "Jr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-06-22",
        "last_updated": "2018-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NC",
            "license": "2220",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5918628",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• D Sim Siceloff DDS PA
• Sara Daffron, MD
• Cherise Monet Dailey, NP
• Kierra Dalton
• Heather Dancy, DBH, LCSW, MSW
• Davidson Behavioral Health & Psychotherapy, PLLC
• Davidson Charter Academy
• Davidson County
• Davidson County Department of Senior Services
• Davidson County Public Schools Supe

• All providers in Lexington, NC
• Optometrist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2018; 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.