Active NPI
Eyecarecenter OD PA
- Optometrist
- North Wilkesboro, NC
National Provider Identifier
1154739563
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- Legal business name
- EYECARECENTER OD PA
- Practice address
- 190 Independence Ave Ste a
North Wilkesboro, NC 28659-4270 - Phone
- (336) 667-6782
- Fax
- (336) 667-7968
- NPI assigned
- Jul 29, 2014
- Organization subpart
- Yes
- Parent organization
- EYECARECENTER OD PA
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Alison Bailey, OD
- Title
- Authorized Official
- Phone
- (636) 200-4393
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | Primary |
Addresses
Primary practice location
190 Independence Ave Ste a
North Wilkesboro, NC 28659-4270
Mailing address
PO Box 207261
Dallas, TX 75320-7261
Phone (636) 200-4393
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 02AUG | Other | NC | BCBSNC |
| 0222680033 | Other | NC | SUPPLIER NUMBER |
| 1154739563 | Medicaid | NC |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NC
Enrollment records 1
Other NPIs on the same Medicare enrollment 40
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
National Provider Directory
National Provider Directory- Part of
- Oecc
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Optometrist
- King, NC
- NPI 1528069234
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1406592000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1740355200000",
"number": "1154739563",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 207261",
"city": "DALLAS",
"state": "TX",
"postal_code": "753207261",
"telephone_number": "636-200-4393",
"fax_number": "636-527-0766"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "190 INDEPENDENCE AVE STE A",
"city": "NORTH WILKESBORO",
"state": "NC",
"postal_code": "286594270",
"telephone_number": "336-667-6782",
"fax_number": "336-667-7968"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "EYECARECENTER OD PA",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "EYECARECENTER OD PA",
"enumeration_date": "2014-07-29",
"last_updated": "2025-02-24",
"certification_date": "2025-02-24",
"status": "A",
"authorized_official_last_name": "BAILEY",
"authorized_official_first_name": "ALISON",
"authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
"authorized_official_telephone_number": "636-200-4393",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "OD"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Optometrist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBSNC",
"identifier": "02AUG",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SUPPLIER NUMBER",
"identifier": "0222680033",
"state": "NC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1154739563",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in North Wilkesboro, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2025; 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.