Individual provider Active NPI

J Daniel Robinson III, OD

  • Optometrist
  • Wallace, NC
National Provider Identifier
1205815883
Registry record updated Mar 26, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
0927 Issued in NC
Practice address
321 East Main Street
Wallace, NC 28466-2723
Phone
(910) 285-3167
Fax
(910) 285-2837
NPI assigned
Jan 12, 2006
Last updated
Mar 26, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 0927 NC Primary

Addresses

Primary practice location

321 East Main Street
Wallace, NC 28466-2723

Mailing address

PO Box 609
Wallace, NC 28466-0609
Phone (910) 285-3167

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
I20080318000834 NC Practitioner - Optometry 6800875360

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0927NCMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Cape Fear Retinal Associates PC Past Accepting new patients
Optometric Associates, P. a. Optometrist Past Accepting new patients

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1137024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1206489600000",
    "number": "1205815883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 609",
            "city": "WALLACE",
            "state": "NC",
            "postal_code": "284660609",
            "telephone_number": "910-285-3167",
            "fax_number": "910-285-2837"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "321 EAST MAIN STREET",
            "city": "WALLACE",
            "state": "NC",
            "postal_code": "284662723",
            "telephone_number": "910-285-3167",
            "fax_number": "910-285-2837"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBINSON",
        "first_name": "J",
        "middle_name": "DANIEL",
        "name_suffix": "III",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-12",
        "last_updated": "2008-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NC",
            "license": "0927",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wallace, NC

Sources for this page

Verify at the official NPI Registry.