Individual provider Active NPI

Kerry M Reeves, O.D.

  • Optometrist
  • Fayetteville, NC
National Provider Identifier
1003818964
Registry record updated Jan 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
NC1779 Issued in NC
Practice address
131 Glensford Dr Ste 105
Fayetteville, NC 28314
Phone
(910) 860-2020
Fax
(910) 864-3719
NPI assigned
Aug 11, 2005
Last updated
Jan 12, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 12, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X NC1779 NC Primary
Optometrist 152W00000X OPT002735 GA

Addresses

Primary practice location

131 Glensford Dr Ste 105
Fayetteville, NC 28314

Mailing address

131 Glensford Dr Ste 105
Fayetteville, NC 28314-2365
Phone (910) 860-2020

Other practice location 1

2709 Meredyth Dr
Suite 110
Albany, GA 31707-0222
Phone (229) 432-7012

Other identifiers 1

IdentifierTypeStateIssuer
890922YMedicaidNC

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20190507001038 NC Practitioner - Optometry 7416054820 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University Alabama Birmingham - School of Optometry, 1999
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

131 Glensford Dr
Suite 105
Fayetteville, NC 28314-2365
Phone (910) 860-2020

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery50

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPT002735GAMDOptometrist
NC1779NCMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Optometry Optometrist CurrentSince Jan 1, 2019 Accepting new patients
Advanced Optometry Kerry M Reeves OD SC Optometrist Current Accepting new patients
Newton Optometric Center P C Optometrist Past Accepting new patients
Maiden Optometric Eye Care Center, PLLC Optometrist Past Accepting new patients
Newton Optometric Center, PLLC Optometrist PastSince Oct 1, 2003 Accepting new patients
Claremont Optometric Eye Care Center, PLLC Optometrist PastSince Nov 1, 2003 Accepting new patients

Locations

131 Glensford Dr
Ste 105
Fayetteville, NC 28314
Phone (910) 860-1035

2000 Coastal Grand Cir
Ste 515
Myrtle Beach, SC 29577
Phone (834) 830-4678

Networks

  • devoted network organization-84bf27aa-506a-49c4-8818-702cf5e8efb3
  • devoted network organization-0f7f8d4f-1035-4992-8c02-dc86d12e700e

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1123718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768176000000",
    "number": "1003818964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "131 GLENSFORD DR STE 105",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283142365",
            "telephone_number": "910-860-2020",
            "fax_number": "910-864-3719"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "131 GLENSFORD DR STE 105",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "28314",
            "telephone_number": "910-860-2020",
            "fax_number": "910-864-3719"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2709 Meredyth Dr",
            "address_2": "Suite 110",
            "address_purpose": "LOCATION",
            "city": "Albany",
            "state": "GA",
            "postal_code": "317070222",
            "country_code": "US",
            "telephone_number": "229-432-7012",
            "fax_number": "229-435-0211",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REEVES",
        "first_name": "KERRY",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-11",
        "last_updated": "2026-01-12",
        "certification_date": "2026-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NC",
            "license": "NC1779",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "GA",
            "license": "OPT002735",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "890922Y",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, NC

Sources for this page

Verify at the official NPI Registry.