Prophetice Vision Care

Primary specialty

Customized Equipment (DME)Taxonomy code 332BC3200X

Legal business name

PROPHETICE VISION CARE

Practice address

204 Kenmore St N
Wilson, NC 27893-1848

Phone

(252) 366-3191

NPI assigned

Jul 9, 2015

Organization subpart

No

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

Authorized official

Name

Ms. Amanda Delores AllenNPI 1316345309

Title

Owner

Phone

(252) 366-3191

Specialties & licenses 1

Addresses

Practitioners 1

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

• Amanda Delores Allen

  • Customized Equipment (DME)
  • Wilson, NC
  • NPI 1316345309
  NPD (past) Authorized official

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

{
    "created_epoch": "1436400000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1436400000000",
    "number": "1174907018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "204 KENMORE ST N",
            "city": "WILSON",
            "state": "NC",
            "postal_code": "278931848",
            "telephone_number": "252-366-3191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "204 KENMORE ST N",
            "city": "WILSON",
            "state": "NC",
            "postal_code": "278931848",
            "telephone_number": "252-366-3191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROPHETICE VISION CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-09",
        "last_updated": "2015-07-09",
        "status": "A",
        "authorized_official_last_name": "ALLEN",
        "authorized_official_first_name": "AMANDA",
        "authorized_official_middle_name": "DELORES",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "252-366-3191",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Customized Equipment (DME) in Wilson, NC
• Providers in Wilson, NC by specialty
• Customized Equipment (DME) in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2015; 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.