Individual provider Active NPI

Richard Gregory Langellotti, O.D.

  • Optometrist
  • Wilson, NC
National Provider Identifier
1154326163
Registry record updated Feb 22, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1667 Issued in NC
Practice address
2500 Forest Hills Rd W
Wilson, NC 27893-3461
Phone
(252) 291-3939
Fax
(252) 822-0033
NPI assigned
Jun 16, 2005
Last updated
Feb 22, 2015By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 22, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1667 NC Primary
Corneal and Contact Management Optometrist 152WC0802X 1667 NC

Addresses

Primary practice location

2500 Forest Hills Rd W
Wilson, NC 27893-3461

Mailing address

2310 Finley Ridge LN
Raleigh, NC 27615-4047
Phone (919) 924-6147

Other identifiers 1

IdentifierTypeStateIssuer
891222LMedicaidNC

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
I20080110000710 NC Practitioner - Optometry 0749361137 Practice locations: Rocky Mount, NC; Wilson, NC

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1667NCMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Richard G. Langellotti, OD Optometrist PastSince Jan 1, 1990 Accepting new patients
Richard G. Langellotti, OD Optometrist PastSince Jan 1, 1990 Accepting new patients
Pioneer Valley Eye Associates, PC Optometrist PastSince Jul 8, 1996 Accepting new patients
Richard G. Langellotti, OD Optometrist PastSince Jan 1, 1990 Accepting new patients
Richard G. Langellotti Optometrist PastSince Jan 1, 1990 Accepting new patients

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": "1118880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1424563200000",
    "number": "1154326163",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2310 FINLEY RIDGE LN",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276154047",
            "telephone_number": "919-924-6147",
            "fax_number": "919-237-9267"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 FOREST HILLS RD W",
            "city": "WILSON",
            "state": "NC",
            "postal_code": "278933461",
            "telephone_number": "252-291-3939",
            "fax_number": "252-822-0033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANGELLOTTI",
        "first_name": "RICHARD",
        "middle_name": "GREGORY",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-16",
        "last_updated": "2015-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NC",
            "license": "1667",
            "primary": true
        },
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "NC",
            "license": "1667",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "891222L",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilson, NC

Sources for this page

Verify at the official NPI Registry.