Organization Active NPI

Myeyedr Optometry of North Carolina, PLLC

  • Optometrist
  • Cary, NC
National Provider Identifier
1134523574
Registry record updated May 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
MYEYEDR OPTOMETRY OF NORTH CAROLINA, PLLC
Practice address
2075 Renaissance Park PL
Cary, NC 27513-2263
Phone
(919) 655-0625
Fax
(919) 655-0627
NPI assigned
Oct 14, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 29, 2022

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

Authorized official

Name
Sue Healey
Title
Secretary
Phone
(703) 847-8899

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X Primary

Addresses

Primary practice location

2075 Renaissance Park PL
Cary, NC 27513-2263

Mailing address

8614 Westwood Center Dr FL 9
Vienna, VA 22182-2442
Phone (703) 847-8899

Other names 1

  • Myeyedr Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130904000726 NC Part B Supplier - Clinic/Group Practice 6608019096 Receives reassigned benefits from 258 practitioners
This NPI is an additional NPI on the enrollment

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
34D2300798Myeyedr Optometry of North Carolina, PLLC2075 Renaissance Park PL, Cary, NC 27513Certificate of waiverMar 14, 2028

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1413244800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1653782400000",
    "number": "1134523574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8614 WESTWOOD CENTER DR FL 9",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221822442",
            "telephone_number": "703-847-8899",
            "fax_number": "571-223-6780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2075 RENAISSANCE PARK PL",
            "city": "CARY",
            "state": "NC",
            "postal_code": "275132263",
            "telephone_number": "919-655-0625",
            "fax_number": "919-655-0627"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MYEYEDR OPTOMETRY OF NORTH CAROLINA, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-14",
        "last_updated": "2022-05-29",
        "certification_date": "2022-05-29",
        "status": "A",
        "authorized_official_last_name": "HEALEY",
        "authorized_official_first_name": "SUE",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "703-847-8899"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Myeyedr",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Myeyedr",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Cary, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.