Clerico Optometry, P.a.

Primary specialty

OptometristTaxonomy code 152W00000X

License

0912 Issued in NC

Legal business name

CLERICO OPTOMETRY, P.A.

Practice address

3528 Yadkinville Rd
Winston Salem, NC 27106-2535

Phone

(336) 924-6811

Fax

(336) 922-4375

NPI assigned

Feb 28, 2007

Organization subpart

No

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

Authorized official

Name

Dr. John Clerico, O.D.

Title

President

Phone

(336) 924-6811

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

Practitioners 2

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

• Terry L. Davis, O.D.

  • Optometrist
  • Winston Salem, NC
  • NPI 1093837916
  NPD (past)
• Terry W Ellington, O.D.

  • Optometrist
  • Winston Salem, NC
  • NPI 1093719080
  NPD (past)

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

{
    "created_epoch": "1172620800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208649600000",
    "number": "1164559878",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3528 YADKINVILLE RD",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271062535",
            "telephone_number": "336-924-6811",
            "fax_number": "336-922-4375"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3528 YADKINVILLE RD",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271062535",
            "telephone_number": "336-924-6811",
            "fax_number": "336-922-4375"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLERICO OPTOMETRY, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-28",
        "last_updated": "2008-04-20",
        "status": "A",
        "authorized_official_last_name": "CLERICO",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "336-924-6811",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "NC",
            "license": "0912",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD NC",
            "identifier": "09158",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8909158",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jane Brethauer Cleland
• Dennis Mark Clemens, MD
• Caitlin Marie Clement, CRNA
• Dalice D Clement
• Grace Taiyu Evadare Clements
• John Clerico, O.D.
• Benicia Elaine Cleveland, MED, LAT, ATC
• Barbara Ann Clifford, MD
• Lucy M Clifford, MS, CCC-SLP
• Bonnie M. Clifton, RPSGT REEGT

• Optometrist in Winston Salem, NC
• Providers in Winston Salem, NC by specialty
• Optometrist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.