Individual provider Active NPI

Kris Janik Roy, O.D.

  • Optometrist
  • Wake Forest, NC
National Provider Identifier
1023321767
Registry record updated Oct 8, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
NC1649 Issued in NC
Practice address
2114 S Main St
Wake Forest, NC 27587-8817
Phone
(919) 556-1530
NPI assigned
Jul 23, 2010
Last updated
Oct 8, 2014By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 8, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X NC1649 NC Primary

Addresses

Primary practice location

2114 S Main St
Wake Forest, NC 27587-8817

Mailing address

12441 Bayleaf Church Rd
Raleigh, NC 27614-9168
Phone (919) 556-1530

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
I20110321000474 NC Practitioner - Optometry 6709069370 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Ohio State University - College of Optometry, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2114 S Main St
Wake Forest, NC 27587-8817
Phone (919) 556-1530

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery20

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
NC1649NCMDOptometrist
1649NCMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Southern Eye Care, O.D., PLLC Optometrist CurrentSince Nov 1, 2014 Accepting new patients
Clark Optometric Center PA Optometrist PastSince Mar 1, 2021 Accepting new patients
Triangle Vision Care, O.D., P.a. Optometrist Past Accepting new patients
Contact Lens Institute, Optometry, PA Optometrist Past Accepting new patients
Triangle Eye Care, OD, PA Optometrist Past Accepting new patients

Locations

2114 S Main St
Wake Forest, NC 27587
Phone (919) 556-1530

Organizations & group practices 5

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": "1279843200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1412726400000",
    "number": "1023321767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12441 BAYLEAF CHURCH RD",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276149168",
            "telephone_number": "919-556-1530",
            "fax_number": "919-556-6769"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2114 S MAIN ST",
            "city": "WAKE FOREST",
            "state": "NC",
            "postal_code": "275878817",
            "telephone_number": "919-556-1530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROY",
        "first_name": "KRIS",
        "middle_name": "JANIK",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-07-23",
        "last_updated": "2014-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NC",
            "license": "NC1649",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wake Forest, NC

Sources for this page

Verify at the official NPI Registry.