Individual provider Active NPI

McKinley Caroline Johnson

  • Optometrist
  • Benson, NC
National Provider Identifier
1053282285
Registry record updated Sep 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2879 Issued in NC
Practice address
113 W Main St
Benson, NC 27504-1343
Phone
(919) 894-7570
Fax
(919) 894-4674
NPI assigned
Sep 12, 2025
Last updated
Sep 12, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2879 NC Primary

Addresses

Primary practice location

113 W Main St
Benson, NC 27504-1343

Mailing address

113 W Main St
Benson, NC 27504-1343
Phone (919) 894-7570

Other practice location 1

124 E Main St
Clinton, NC 28328-4029
Phone (910) 592-1908

Other practice location 2

432 W Broad St
Elizabethtown, NC 28337-9398
Phone (910) 592-1908

Other practice location 3

305 W Roseboro St
Roseboro, NC 28382-8786
Phone (910) 525-5296

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
I20260102000960 NC Practitioner - Optometry 9638665268 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pec Optometry Group PAGroup PAC ID 0547541013, 5 clinicians

Practice addresses (Care Compare)

113 W Main St
Benson, NC 27504-1343
Phone (919) 894-7570

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2879NCMDAthletic Trainer

Practice roles

OrganizationSpecialtyStatusNew patients
Pec Optometry Group, P.a. Optometrist CurrentSince Nov 3, 2025 Accepting new patients
Pec Optometry Group, P.a. Optometrist CurrentSince Nov 3, 2025 Accepting new patients

Locations

113 W Main St
Benson, NC 27504
Phone (919) 894-7570

124 E Main St
Clinton, NC 28328
Phone (910) 485-3937

432 W Broad St
Elizabethtown, NC 28337
Phone (910) 592-1908

Organizations & group practices 2

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": "1757635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757635200000",
    "number": "1053282285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "113 W MAIN ST",
            "city": "BENSON",
            "state": "NC",
            "postal_code": "275041343",
            "telephone_number": "919-894-7570",
            "fax_number": "919-894-4674"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "113 W MAIN ST",
            "city": "BENSON",
            "state": "NC",
            "postal_code": "275041343",
            "telephone_number": "919-894-7570",
            "fax_number": "919-894-4674"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "124 E Main St",
            "address_purpose": "LOCATION",
            "city": "Clinton",
            "state": "NC",
            "postal_code": "283284029",
            "country_code": "US",
            "telephone_number": "910-592-1908",
            "fax_number": "910-596-0190",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "432 W Broad St",
            "address_purpose": "LOCATION",
            "city": "Elizabethtown",
            "state": "NC",
            "postal_code": "283379398",
            "country_code": "US",
            "telephone_number": "910-592-1908",
            "fax_number": "910-596-0190",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "305 W Roseboro St",
            "address_purpose": "LOCATION",
            "city": "Roseboro",
            "state": "NC",
            "postal_code": "283828786",
            "country_code": "US",
            "telephone_number": "910-525-5296",
            "fax_number": "910-525-5285",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "MCKINLEY",
        "middle_name": "CAROLINE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-09-12",
        "last_updated": "2025-09-12",
        "certification_date": "2025-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NC",
            "license": "2879",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Benson, NC

Sources for this page

Verify at the official NPI Registry.