Southern Optometry Group

Primary specialty

OptometristTaxonomy code 152W00000X

License

1342 Issued in NC

Legal business name

SOUTHERN OPTOMETRY GROUP

Practice address

10050 Glenwood Ave
Raleigh, NC 27617-8436

Phone

(919) 596-3300

NPI assigned

Sep 20, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Mark Allen Schoning, ODNPI 1205962347

Title

Owner

Phone

(919) 460-7470

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Locations

Practitioners 3

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

• Mark Allen Schoning, O.D.

  • Optometrist
  • Cary, NC
  • NPI 1205962347
  Medicare reassignment Authorized official
• Kimberly L Bowers, O.D.

  • Optometrist
  • Garner, NC
  • NPI 1437293743
  NPD (past)
• Eileen Marie Walsh, OD

  • Optometrist
  • Raleigh, NC
  • NPI 1598731341
  NPD (past)

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

{
    "created_epoch": "1190246400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1395100800000",
    "number": "1225224595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7724 BERRY CREST AVE",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276178326",
            "telephone_number": "919-596-3300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10050 GLENWOOD AVE",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276178436",
            "telephone_number": "919-596-3300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN OPTOMETRY GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-20",
        "last_updated": "2014-03-18",
        "status": "A",
        "authorized_official_last_name": "SCHONING",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "ALLEN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "919-460-7470",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "NC",
            "license": "1342",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "890936N",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Southern Wellness Center
• Southern Wellness Home Care Services LLC
• Louise Southern
• Southlight Healthcare
• Southlight Healthcare

• Optometrist in Raleigh, NC
• Providers in Raleigh, NC by specialty
• Optometrist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2014; 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.