Organization Active NPI

Carolina Optical Partners

Doing business as carolina optical shop

  • Eyewear Supplier
  • Fayetteville, NC
National Provider Identifier
1194920454
Registry record updated Dec 27, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Eyewear SupplierTaxonomy code 332H00000X
License
21583 Issued in NC
Legal business name
CAROLINA OPTICAL PARTNERS
Doing business as
carolina optical shop
Practice address
2047 Valleygate Dr
Fayetteville, NC 28304-3688
Phone
(910) 485-3937
Fax
(910) 221-3671
NPI assigned
Jun 18, 2007
Last updated
Dec 27, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 27, 2007

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

Authorized official

Name
Deborah Woodcock
Title
Secretary
Phone
(910) 485-3937

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Eyewear Supplier 332H00000X 21583 NC Primary

Addresses

Primary practice location

2047 Valleygate Dr
Fayetteville, NC 28304-3688

Mailing address

2047 Valleygate Dr
Fayetteville, NC 28304-3688
Phone (910) 485-3937

Other identifiers 1

IdentifierTypeStateIssuer
8802076MedicaidNC

Other names 1

  • carolina optical shop Doing business as

National Provider Directory

National Provider Directory

Locations

2047 Valleygate Dr
Fayetteville, NC 28304
Phone (910) 485-3937

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1182124800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1198713600000",
    "number": "1194920454",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2047 VALLEYGATE DR",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283043688",
            "telephone_number": "910-485-3937",
            "fax_number": "910-221-3671"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2047 VALLEYGATE DR",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283043688",
            "telephone_number": "910-485-3937",
            "fax_number": "910-221-3671"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAROLINA OPTICAL PARTNERS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-18",
        "last_updated": "2007-12-27",
        "status": "A",
        "authorized_official_last_name": "WOODCOCK",
        "authorized_official_first_name": "DEBORAH",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "910-485-3937"
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "NC",
            "license": "21583",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8802076",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "carolina optical shop",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fayetteville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2007; 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.