Individual provider Active NPI

Zophia Rendon, OD

  • Optometrist
  • North Wilkesboro, NC
National Provider Identifier
1215372065
Registry record updated May 4, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2348 Issued in NC
Practice address
316 Main St
North Wilkesboro, NC 28659-4402
Phone
(336) 667-6782
Fax
(336) 667-7968
NPI assigned
May 7, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 4, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2348 NC Primary

Addresses

Primary practice location

316 Main St
North Wilkesboro, NC 28659-4402

Mailing address

316 Main St
North Wilkesboro, NC 28659-4402
Phone (336) 667-6782

Other identifiers 1

IdentifierTypeStateIssuer
1215372065MedicaidNC

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
I20150115002066 NC Practitioner - Optometry 5193049450 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Eyecarecenter OD PAGroup PAC ID 7315834462, 71 clinicians

Practice addresses (Care Compare)

190 Independence Ave
Suite a
North Wilkesboro, NC 28659-4270
Phone (336) 667-6782

819 Tiffany Blvd
Rocky Mount, NC 27804-1812
Phone (252) 972-2020

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery14

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2348NCMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Eyecarecenter OD PA Optometrist CurrentSince Jul 1, 2014 Accepting new patients
Eyecarecenter, O.D., P.a. Optometrist CurrentSince Jul 1, 2014 Accepting new patients
Eyecarecenter OD PA Optometrist Current Accepting new patients
Eyecarecenter OD PA Optometrist Past Accepting new patients

Locations

190 Independence Ave
Ste A
North Wilkesboro, NC 28659
Phone (336) 667-6782

316 Main St
North Wilkesboro, NC 28659
Phone (336) 667-6782

819 Tiffany Blvd
Rocky Mount, NC 27804
Phone (252) 972-2020

800 S Stratford Rd
Winston Salem, NC 27103
Phone (336) 765-5788

Interoperability endpoints

  • Direct secure messaging: zrendon@direct.eyecare-partners.com

Organizations & group practices 4

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

NPI Registry JSON

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

{
    "created_epoch": "1367884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1430697600000",
    "number": "1215372065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "316 MAIN ST",
            "city": "NORTH WILKESBORO",
            "state": "NC",
            "postal_code": "286594402",
            "telephone_number": "336-667-6782",
            "fax_number": "336-667-7968"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "316 MAIN ST",
            "city": "NORTH WILKESBORO",
            "state": "NC",
            "postal_code": "286594402",
            "telephone_number": "336-667-6782",
            "fax_number": "336-667-7968"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RENDON",
        "first_name": "ZOPHIA",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-05-07",
        "last_updated": "2015-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NC",
            "license": "2348",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1215372065",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in North Wilkesboro, NC

Sources for this page

Verify at the official NPI Registry.