NPIMap

Organization Active NPI

Piedmont Eye Surgical and Laser PLLC

  • Ophthalmology Physician
  • Greensboro, NC
National Provider Identifier
1225281876
Registry record updated Dec 30, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
200600935 Issued in NC
Legal business name
PIEDMONT EYE SURGICAL AND LASER PLLC
Practice address
1002 N Church St
Suite 200
Greensboro, NC 27401-1439
Phone
(336) 854-4441
Fax
(336) 854-7883
NPI assigned
Oct 28, 2008
Last updated
Dec 30, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2008

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

Authorized official

Name
Timothy R Bevis, MDNPI 1598710923
Title
President
Phone
(336) 854-4441

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
Ophthalmology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207W00000X 200600935 NC Primary

Addresses

Primary practice location

1002 N Church St
Suite 200
Greensboro, NC 27401-1439

Mailing address

1002 N Church St
Suite 200
Greensboro, NC 27401-1439
Phone (336) 854-4441

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20081211000654 NC Part B Supplier - Clinic/Group Practice 0345301115 Receives reassigned benefits from 3 practitioners
Practice locations: Greensboro, NC; Thomasville, NC

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

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": "1225152000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1230595200000",
    "number": "1225281876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1002 N CHURCH ST",
            "address_2": "SUITE 200",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274011439",
            "telephone_number": "336-854-4441",
            "fax_number": "336-854-7883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1002 N CHURCH ST",
            "address_2": "SUITE 200",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274011439",
            "telephone_number": "336-854-4441",
            "fax_number": "336-854-7883"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PIEDMONT EYE SURGICAL AND LASER PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-28",
        "last_updated": "2008-12-30",
        "status": "A",
        "authorized_official_last_name": "BEVIS",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "336-854-4441",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "NC",
            "license": "200600935",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Dec 30, 2008; 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.