NPIMap

Organization Active NPI

Pec Optometry Group, P.a.

  • Optometrist
  • Roseboro, NC
National Provider Identifier
1114504958
Registry record updated Mar 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
PEC OPTOMETRY GROUP, P.A.
Practice address
305 W Roseboro St
Roseboro, NC 28382-8786
Phone
(910) 525-5296
Fax
(910) 525-5285
NPI assigned
Mar 26, 2021
Last updated
Mar 26, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2021

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

Authorized official

Name
Mr. Roy Max Raynor Jr., ODNPI 1396793477
Title
OD/Owner
Phone
(919) 894-7579

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X NU Primary

Addresses

Primary practice location

305 W Roseboro St
Roseboro, NC 28382-8786

Mailing address

113 W Main St
Benson, NC 27504-1343
Phone (919) 894-7579

National Provider Directory

National Provider Directory
Tax ID family
Pec Optometry Group PA5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Locations

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

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1616716800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1616716800000",
    "number": "1114504958",
    "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": "919-894-7579",
            "fax_number": "919-894-4674"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 W ROSEBORO ST",
            "city": "ROSEBORO",
            "state": "NC",
            "postal_code": "283828786",
            "telephone_number": "910-525-5296",
            "fax_number": "910-525-5285"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEC OPTOMETRY GROUP, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-26",
        "last_updated": "2021-03-26",
        "certification_date": "2021-03-26",
        "status": "A",
        "authorized_official_last_name": "RAYNOR",
        "authorized_official_first_name": "ROY",
        "authorized_official_middle_name": "MAX",
        "authorized_official_title_or_position": "OD/OWNER",
        "authorized_official_telephone_number": "919-894-7579",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roseboro, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.