Individual provider Active NPI

Doyle S Bedsole, O.D.

  • Optometrist
  • Raleigh, NC
National Provider Identifier
1164592523
Registry record updated Nov 7, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1251 Issued in NC
Practice address
101 Sawmill Rd
Raleigh, NC 27615-6148
Phone
(919) 847-0051
Fax
(919) 846-9003
NPI assigned
Nov 9, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1251 NC Primary

Addresses

Primary practice location

101 Sawmill Rd
Raleigh, NC 27615-6148

Mailing address

101 Sawmill Rd
Raleigh, NC 27615-6148
Phone (919) 847-0051

Other identifiers 4

IdentifierTypeStateIssuer
2348490OtherNCGROUP PTAN
1164592523OtherNCNPI
2466989AOtherNCPTAN
1831258912OtherNCGROUP NPI

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
I20051021000608 NC Practitioner - Optometry 6709801236 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1251NCMDPediatric Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Clark Optometric Center PA Optometrist CurrentSince Aug 22, 2022 Accepting new patients

Locations

2216 E NC Highway 54
Durham, NC 27713
Phone (919) 544-2020

101 Sawmill Rd
Raleigh, NC 27615
Phone (919) 847-0051

7016 Harps Mill Rd
Ste 103
Raleigh, NC 27615
Phone (919) 847-6889

1829 Doctors Dr
Sanford, NC 27330
Phone (919) 776-2032

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1163030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1352246400000",
    "number": "1164592523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 SAWMILL RD",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276156148",
            "telephone_number": "919-847-0051",
            "fax_number": "919-846-9003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 SAWMILL RD",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276156148",
            "telephone_number": "919-847-0051",
            "fax_number": "919-846-9003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEDSOLE",
        "first_name": "DOYLE",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-09",
        "last_updated": "2012-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NC",
            "license": "1251",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP PTAN",
            "identifier": "2348490",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1164592523",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "2466989A",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NPI",
            "identifier": "1831258912",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

Verify at the official NPI Registry.