Premier Family Eye Care OD PLLC

Primary specialty

OptometristTaxonomy code 152W00000X

License

2021 Issued in NC

Legal business name

PREMIER FAMILY EYE CARE OD PLLC

Practice address

6044 W Highway 74
Indian Trail, NC 28079-3591

Phone

(704) 821-3937

NPI assigned

Apr 27, 2010

Last updated

Jan 4, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Timothy Mack, ODNPI 1225442767

Title

Optometrist

Phone

(704) 821-3937

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Locations

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Timothy Mack

  • Optometrist
  • Dublin, OH
  • NPI 1225442767

  NC

  Medicare reassignment Care Compare group NPD Authorized official
• Matthew Jon McPheron, OD

  • Optometrist
  • Indian Trail, NC
  • NPI 1639878226
  Medicare reassignment Care Compare group NPD
• Laura Lee Perlaky Young, O.D.

  • Optometrist
  • Indian Trail, NC
  • NPI 1083657639
  Medicare reassignment Care Compare group NPD
• Stacy M Schorner, O.D.

  • Optometrist
  • Monroe, NC
  • NPI 1932375367
  Medicare reassignment Care Compare group
• Ryan C Corte, OD

  • Optometrist
  • Asheville, NC
  • NPI 1336402445
  NPD (past)

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

{
    "created_epoch": "1272326400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1704326400000",
    "number": "1063739274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6044 W HIGHWAY 74",
            "city": "INDIAN TRAIL",
            "state": "NC",
            "postal_code": "280793591",
            "telephone_number": "704-821-3937",
            "fax_number": "704-821-3938"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6044 W HIGHWAY 74",
            "city": "INDIAN TRAIL",
            "state": "NC",
            "postal_code": "280793591",
            "telephone_number": "704-821-3937"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER FAMILY EYE CARE OD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-04-27",
        "last_updated": "2024-01-04",
        "certification_date": "2024-01-04",
        "status": "A",
        "authorized_official_last_name": "MACK",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "704-821-3937",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "NC",
            "license": "2021",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Julie Pittman, DPT
• Lisa Ann-Longobardo Plesa, D.C.
• Tina Fields Pompey, DDS
• Alison S. Powell, M.D.
• Kyrle William Preis IV, DPT
• Kristie K Pruno, CCC-SLP
• Ruth Dolores Psetas, NP
• Devyn Kay Pugh, NCC, LCMHCA
• Kevin Paul Pultorak, RPH
• Ryan Purcell, CPHT

• Optometrist in Indian Trail, NC
• Providers in Indian Trail, NC by specialty
• Optometrist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2024; 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.