NPIMap

Organization Active NPI

Raleigh Eye Center, PA

  • Ophthalmology Physician
  • South Hill, VA
National Provider Identifier
1003235508
Registry record updated Mar 10, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
RALEIGH EYE CENTER, PA
Practice address
129 E Ferrell St
South Hill, VA 23970-2101
Phone
(464) 447-3220
NPI assigned
Apr 11, 2014
Organization subpart
Yes
Parent organization
RALEIGH EYE CENTER, PAAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 10, 2015

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

Authorized official

Name
Leslie R Arnold
Title
Business Manager
Phone
(919) 876-2427

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Corneal and Contact Management OptometristGroup: 193200000X MULTI-SPECIALTY GROUP 152WC0802X
Ophthalmology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207W00000X Primary
Eyewear Supplier 332H00000X

Addresses

Primary practice location

129 E Ferrell St
South Hill, VA 23970-2101

Mailing address

3320 Executive Dr
Suite 111
Raleigh, NC 27609-7445
Phone (919) 876-2427

Other identifiers 1

IdentifierTypeStateIssuer
1902857675OtherNCPRIMARY NPI

Other names 1

  • Raleigh Eye Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140908002738 VA Part B Supplier - Clinic/Group Practice 7113944125 Receives reassigned benefits from 3 practitioners
Practice locations: South Hill, VA

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
The Raleigh Eye Center P2 organizations share this tax ID, including this one
Part of
The Raleigh Eye Center P

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

6104 Fayetteville Rd
Ste 108
Durham, NC 27713
Phone (919) 572-0050

730 S Scales St
Reidsville, NC 27320
Phone (336) 347-7415

870 N Mecklenburg Ave
South Hill, VA 23970

Practitioners & affiliated clinicians

Practitioners 14

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1397174400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1425945600000",
    "number": "1003235508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3320 EXECUTIVE DR",
            "address_2": "SUITE 111",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276097445",
            "telephone_number": "919-876-2427",
            "fax_number": "919-790-8423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "129 E FERRELL ST",
            "city": "SOUTH HILL",
            "state": "VA",
            "postal_code": "239702101",
            "telephone_number": "464-447-3220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RALEIGH EYE CENTER, PA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "RALEIGH EYE CENTER, PA",
        "enumeration_date": "2014-04-11",
        "last_updated": "2015-03-10",
        "status": "A",
        "authorized_official_last_name": "ARNOLD",
        "authorized_official_first_name": "LESLIE",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "BUSINESS MANAGER",
        "authorized_official_telephone_number": "919-876-2427"
    },
    "taxonomies": [
        {
            "code": "152WC0802X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRIMARY NPI",
            "identifier": "1902857675",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Raleigh Eye Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in South Hill, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.