Organization Active NPI

National Optometric Center PLC

  • Optometrist
  • Roanoke, VA
National Provider Identifier
1184679052
Registry record updated Dec 18, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
0618000577 Issued in VA
Legal business name
NATIONAL OPTOMETRIC CENTER PLC
Practice address
1507 Hershberger Rd NW
Unit C
Roanoke, VA 24012-7319
Phone
(540) 362-1030
Fax
(540) 362-5574
NPI assigned
May 22, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2017

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

Authorized official

Name
Tammy R Cox, LDONPI 1881750719
Title
Manager / Optician
Phone
(540) 362-1030

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 0618000577 VA Primary

Addresses

Primary practice location

1507 Hershberger Rd NW
Unit C
Roanoke, VA 24012-7319

Mailing address

1507 Hershberger Rd NW
Unit C
Roanoke, VA 24012-7319
Phone (540) 362-1030

Other identifiers 2

IdentifierTypeStateIssuer
1184679052MedicaidVA
009235787MedicaidVA

Other names 1

  • National Optometric Center PLC Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20171213003285 VA Part B Supplier - Clinic/Group Practice 5991063273 Receives reassigned benefits from 2 practitioners
Practice locations: Ridgeway, VA; Roanoke, VA; Vinton, VA

National Provider Directory

National Provider Directory

Locations

4960 Greensboro Rd
Ste 5
Ridgeway, VA 24148
Phone (276) 638-1149

3532 Electric Rd
Roanoke, VA 24018
Phone (540) 776-2930

1507 Hershberger Rd NW
Ste C
Roanoke, VA 24012
Phone (540) 362-0300

5002 Airport Rd NW
Roanoke, VA 24012
Phone (540) 362-1030

1507 Hershberger Rd NW
Roanoke, VA 24012

Practitioners & affiliated clinicians

Practitioners 11

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

NPI Registry JSON

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

{
    "created_epoch": "1148256000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1513555200000",
    "number": "1184679052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1507 HERSHBERGER RD NW",
            "address_2": "UNIT C",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240127319",
            "telephone_number": "540-362-1030",
            "fax_number": "540-362-5574"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1507 HERSHBERGER RD NW",
            "address_2": "UNIT C",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240127319",
            "telephone_number": "540-362-1030",
            "fax_number": "540-362-5574"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NATIONAL OPTOMETRIC CENTER PLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-22",
        "last_updated": "2017-12-18",
        "status": "A",
        "authorized_official_last_name": "COX",
        "authorized_official_first_name": "TAMMY",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "MANAGER / OPTICIAN",
        "authorized_official_telephone_number": "540-362-1030",
        "authorized_official_credential": "LDO"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "VA",
            "license": "0618000577",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1184679052",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009235787",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "National Optometric Center PLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Roanoke, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2017; 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.

Verify at the official NPI Registry.