NPIMap

Organization Active NPI

Eye Consultants of Greensboro

  • Ophthalmic Technician/Technologist
  • Greensboro, NC
National Provider Identifier
1215049291
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmic Technician/TechnologistTaxonomy code 156FX1100X
License
26482 Issued in NC
Legal business name
EYE CONSULTANTS OF GREENSBORO
Practice address
1305 W Wendover Ave
Suite B
Greensboro, NC 27408-8124
Phone
(336) 389-0242
Fax
(336) 389-0263
NPI assigned
Aug 31, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Roy Whitaker Jr., MDNPI 1285638866
Title
Owner
Phone
(336) 389-0242

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
Ophthalmic Technician/TechnologistGroup: 193400000X SINGLE SPECIALTY GROUP 156FX1100X 26482 NC Primary

Addresses

Primary practice location

1305 W Wendover Ave
Suite B
Greensboro, NC 27408-8124

Mailing address

1305 W Wendover Ave
Suite B
Greensboro, NC 27408-8124
Phone (336) 389-0242

Other identifiers 1

IdentifierTypeStateIssuer
8912204MedicaidNC

Other names 1

  • EYE CONSULTANTS OF ASHEBORO Other name

National Provider Directory

National Provider Directory

Locations

1305 W Wendover Ave
Ste B
Greensboro, NC 27408
Phone (336) 389-0242

Practitioners & affiliated clinicians

Practitioners 1

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": "1156982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1215049291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1305 W WENDOVER AVE",
            "address_2": "SUITE B",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274088124",
            "telephone_number": "336-389-0242",
            "fax_number": "336-389-0263"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1305 W WENDOVER AVE",
            "address_2": "SUITE B",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274088124",
            "telephone_number": "336-389-0242",
            "fax_number": "336-389-0263"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYE CONSULTANTS OF GREENSBORO",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-31",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WHITAKER",
        "authorized_official_first_name": "ROY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "336-389-0242",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "156FX1100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Technician/Technologist, Ophthalmic",
            "state": "NC",
            "license": "26482",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8912204",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "EYE CONSULTANTS OF ASHEBORO",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Greensboro, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.