Active NPI
Retina Institute of North Carolina, PC
- Ophthalmology Physician
- Wake Forest, NC
National Provider Identifier
1235468513
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ophthalmology Physician
- License
- 2006-00726
- Legal business name
- RETINA INSTITUTE OF NORTH CAROLINA, PC
- Practice address
- 3211 Rogers Rd
Ste 101
Wake Forest, NC 27587-3890 - Phone
- (919) 453-1462
- Fax
- (919) 453-1473
- NPI assigned
- Dec 15, 2009
- Last updated
- Dec 15, 2009
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Lisa Fogel, MD
- Title
- Owner
- Phone
- (919) 787-8555
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ophthalmology Physician | 207W00000X | 2006-00726 | NC | Primary |
Addresses
Primary practice location
3211 Rogers Rd
Ste 101
Wake Forest, NC 27587-3890
Mailing address
2605 Blue Ridge Rd
Ste 220
Raleigh, NC 27607-6475
Phone (919) 787-8555
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5903995 | Medicaid | NC |
National Provider Directory
National Provider Directory- Tax ID family
- Retina Institute of North Carolina
Other organizations with this tax ID 2
Organizations that report the same tax identification number in the National Provider Directory.
-
- Ophthalmology Physician
- Raleigh, NC
- NPI 1265547483
-
- Ophthalmology Physician
- Smithfield, NC
- NPI 1407110448
Locations
152 Capcom Ave
Ste 102
Wake Forest, NC 27587
Phone (919) 453-1462
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1260835200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1260835200000",
"number": "1235468513",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2605 BLUE RIDGE RD",
"address_2": "STE 220",
"city": "RALEIGH",
"state": "NC",
"postal_code": "276076475",
"telephone_number": "919-787-8555",
"fax_number": "919-787-8112"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3211 ROGERS RD",
"address_2": "STE 101",
"city": "WAKE FOREST",
"state": "NC",
"postal_code": "275873890",
"telephone_number": "919-453-1462",
"fax_number": "919-453-1473"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "RETINA INSTITUTE OF NORTH CAROLINA, PC",
"organizational_subpart": "NO",
"enumeration_date": "2009-12-15",
"last_updated": "2009-12-15",
"status": "A",
"authorized_official_last_name": "FOGEL",
"authorized_official_first_name": "LISA",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "919-787-8555",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "207W00000X",
"taxonomy_group": "",
"desc": "Ophthalmology",
"state": "NC",
"license": "2006-00726",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "5903995",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Wake Forest, NC
- Joanna Davis Reiman, OD
- Taylor Reimold
- Relational Behavioral Health PLLC
- Renewing Paths Counseling Services, PLLC
- Catherine Restrepo, MS, CCC-SLP
- Jennifer Revoir, LCSW
- Jake Reynolds, DMD, MSD
- Jessica H Reynolds, DPT
- Riccobene & Associates I, DDS, P.a. (Riccobene Associates Family Dentistry-Wake Forest)
- Ashley Rice, DPT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.