Individual provider Active NPI

Terry W Ellington, O.D.

  • Optometrist
  • Winston Salem, NC
National Provider Identifier
1093719080
Registry record updated Nov 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1902 Issued in NC
Practice address
8013 N Point Blvd
Winston Salem, NC 27106-3203
Phone
(336) 775-1734
Fax
(336) 775-1734
NPI assigned
Jun 8, 2005
Last updated
Nov 10, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 10, 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 1902 NC Primary

Addresses

Primary practice location

8013 N Point Blvd
Winston Salem, NC 27106-3203

Mailing address

8013 N Point Blvd
Winston Salem, NC 27106-3203
Phone (336) 775-1734

Other practice location 1

204 Ingram Dr
King, NC 27021-8206
Phone (336) 235-4004

Other identifiers 1

IdentifierTypeStateIssuer
8909668MedicaidNC

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
I20040420001569 NC Practitioner - Optometry 9133020357 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Clear View OptometryGroup PAC ID 3577976794, 2 clinicians

Practice addresses (Care Compare)

204 Ingram Dr
King, NC 27021-8206
Phone (336) 235-4004

2910 Reynolda Rd
Winston Salem, NC 27106-3016

8013 N Point Blvd
Winston Salem, NC 27106-3203
Phone (336) 724-5000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1902NCMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
Myeyedr Optometry of North Carolina, PLLC Optometrist Current Accepting new patients
Myeyedr Optometry of North Carolina, PLLC Optometrist CurrentSince Jan 2, 2015 Accepting new patients
Myeyedr Optometry of North Carolina, PLLC Optometrist CurrentSince Jan 2, 2015 Accepting new patients
Clear View Optometry Optometrist CurrentSince Oct 2, 2020 Accepting new patients
Clerico Optometry, P.a. Optometrist Past Accepting new patients

Locations

1960 Randolph Rd
Charlotte, NC 28207
Phone (704) 372-5332

1027 S Main St
Kernersville, NC 27284
Phone (336) 996-2020

204 Ingram Dr
King, NC 27021
Phone (336) 235-4004

2910 Reynolda Rd
Winston Salem, NC 27106
Phone (336) 723-3341

8013 N Point Blvd
Winston Salem, NC 27106
Phone (336) 724-5000

8614 Westwood Center Dr
Fl 9
Vienna, VA 22182

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": "1118188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762732800000",
    "number": "1093719080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8013 N POINT BLVD",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271063203",
            "telephone_number": "336-775-1734",
            "fax_number": "336-775-1734"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8013 N POINT BLVD",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271063203",
            "telephone_number": "336-775-1734",
            "fax_number": "336-775-1734"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "204 Ingram Dr",
            "address_purpose": "LOCATION",
            "city": "King",
            "state": "NC",
            "postal_code": "270218206",
            "country_code": "US",
            "telephone_number": "336-235-4004",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ELLINGTON",
        "first_name": "TERRY",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-08",
        "last_updated": "2025-11-10",
        "certification_date": "2025-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NC",
            "license": "1902",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8909668",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Winston Salem, NC

Sources for this page

Verify at the official NPI Registry.