Individual provider Active NPI

Carlyle Dukes Haywood Jr.

  • Optometrist
  • Troy, NC
National Provider Identifier
1144204579
Registry record updated Nov 23, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1566 Issued in NC
Practice address
326 Albemarle Rd
Troy, NC 27371-3206
Phone
(910) 576-7371
Fax
(910) 576-7372
NPI assigned
Nov 30, 2005
Last updated
Nov 23, 2016By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 23, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1566 NC Primary
Optometrist 152W00000X OE007726P PA

Addresses

Primary practice location

326 Albemarle Rd
Troy, NC 27371-3206

Mailing address

326 Albemarle Rd
Troy, NC 27371-3206
Phone (910) 576-7371

Other identifiers 4

IdentifierTypeStateIssuer
2471739OtherNCMEDICARE PTAN
0925KOtherNCBCBS
410043489OtherNCRR MEDICARE
890925KMedicaidNC

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
I20080528000101 NC Practitioner - Optometry 8628090511 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pennsylvania College of Optometry, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

326 Albemarle Rd
Troy, NC 27371-3206
Phone (910) 576-7371

Merit-based Incentive Payment System (MIPS)

Final score
97.5 of 100Reported as individual
Quality
95
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1566NCMDPsychologist
OE007726PPAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Carlyle Dukes Haywood, Jr. Optometrist CurrentSince Jan 1, 2000 Accepting new patients
Carlyle Dukes Haywood Jr Optometrist CurrentSince Jan 1, 2000 Accepting new patients
Roger W. Luck Past Accepting new patients

Locations

211 W Broad Ave
Rockingham, NC 28379
Phone (910) 997-4949

211 W Broad Ave
#C
Rockingham, NC 28379

211 W Broad Ave
Ste C
Rockingham, NC 28379
Phone (910) 997-4949

326 Albemarle Rd
Troy, NC 27371
Phone (910) 576-7371

Organizations & group practices 4

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": "1133308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1479859200000",
    "number": "1144204579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "326 ALBEMARLE RD",
            "city": "TROY",
            "state": "NC",
            "postal_code": "273713206",
            "telephone_number": "910-576-7371",
            "fax_number": "910-576-7372"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "326 ALBEMARLE RD",
            "city": "TROY",
            "state": "NC",
            "postal_code": "273713206",
            "telephone_number": "910-576-7371",
            "fax_number": "910-576-7372"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAYWOOD",
        "first_name": "CARLYLE",
        "middle_name": "DUKES",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-30",
        "last_updated": "2016-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NC",
            "license": "1566",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PA",
            "license": "OE007726P",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "2471739",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0925K",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "410043489",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "890925K",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Troy, NC

Sources for this page

Verify at the official NPI Registry.