NPIMap

Organization Active NPI

Atlantic Vision Center OD PLLC

Doing business as Atlantic Vision Center

  • Optometrist
  • Wilmington, NC
National Provider Identifier
1124614482
Registry record updated Dec 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
ATLANTIC VISION CENTER OD PLLC
Doing business as
Atlantic Vision Center
Practice address
3910 Shipyard Blvd
Wilmington, NC 28403-6151
Phone
(910) 799-0220
Fax
(910) 799-0712
NPI assigned
Dec 21, 2020
Last updated
Dec 21, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 21, 2020

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

Authorized official

Name
Sara Woodring Brigman, ODNPI 1710970165
Title
President
Phone
(919) 609-1233

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
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X Primary

Addresses

Primary practice location

3910 Shipyard Blvd
Wilmington, NC 28403-6151

Mailing address

5901 Hunters Mill LN
Wilmington, NC 28409-2333
Phone (919) 609-1233

Other names 1

  • Atlantic Vision Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210312000222 NC Part B Supplier - Clinic/Group Practice 2567878796 Receives reassigned benefits from 3 practitioners
Practice locations: Wilmington, NC

National Provider Directory

National Provider Directory

Locations

3910 Shipyard Blvd
Wilmington, NC 28403
Phone (910) 799-0220

Practitioners & affiliated clinicians

Practitioners 3

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": "1608508800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1608508800000",
    "number": "1124614482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5901 HUNTERS MILL LN",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284092333",
            "telephone_number": "919-609-1233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3910 SHIPYARD BLVD",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284036151",
            "telephone_number": "910-799-0220",
            "fax_number": "910-799-0712"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ATLANTIC VISION CENTER OD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-12-21",
        "last_updated": "2020-12-21",
        "certification_date": "2020-12-15",
        "status": "A",
        "authorized_official_last_name": "BRIGMAN",
        "authorized_official_first_name": "SARA",
        "authorized_official_middle_name": "WOODRING",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "919-609-1233",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Atlantic Vision Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Wilmington, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2020; 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.