Carlyle Dukes Haywood, Jr.
Organization Active NPI Optometrist · Troy, NC
NPI 1043357643 · NPPES record last updated Nov 23, 2016
Key facts
- NPI
- 1043357643
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Optometrist 152W00000X
- License
- 1566 (NC)
- Legal business name
- CARLYLE DUKES HAYWOOD, JR.
- Practice address
- 326 Albemarle Rd
Troy, NC 27371-3206 - Phone
- (910) 576-7371
- NPI assigned
- Jan 31, 2007
- Organization subpart
- No
Authorized official
- Name
- Carlyle Haywood
- Title
- Owner
- Phone
- (910) 417-7138
Other NPIs on the same Medicare enrollment 1
Other NPIs with the same Medicare PAC ID 1
Corporate family (same tax ID) 1
Practitioners 6
-
Vanessa M Mills, O.D.
-
Stephanie Corbin, OD
-
Samuel E Cox, O.D.
-
Kevin James Ritter, O.D.
Laboratory certificates & supplier records
Medicare medical equipment & supply locations
| Supplier | Supplies | Medicare assignment |
|---|---|---|
| Carlyle Dukes Haywood, Jr. OD |
Prosthetic Lenses: Conventional Eyeglasses|Prosthetic Lenses: Conventional Contact Lenses | Accepts assignment |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in NC
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20080528000108 | NC | Part B Supplier - Clinic/Group Practice | 2264480029 |
Receives reassigned benefits from 5 practitioners 1 other NPI on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Rockingham, NC; Troy, NC |
| O20100930020946 | NC | DME Supplier - Physician - Optometrist |
2264480029 | Practice locations: Troy, NC |
National Provider Directory
- Tax ID family
- Montgomery Eye Care
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist |
152W00000X | 1566 | NC | Yes |
Addresses
Primary practice location
326 Albemarle Rd
Troy, NC 27371-3206
Mailing address
326 Albemarle Rd
Troy, NC 27371-3206
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 89013HK | Medicaid | NC | |
| DG4307 | Other | NC | RR MEDICARE |
| 2471739 | Other | NC | GROUP MEDICARE |
| 0925K | Other | NC | BCBS |
| 410043489 | Other | NC | RR MEDICARE |
Other providers in Troy, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 23, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.