Individual provider Active NPI

Jill A Greene, O.D.

  • Optometrist
  • Carolina Shores, NC
National Provider Identifier
1235506833
Registry record updated Oct 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2425 Issued in NC
Practice address
75 Emerson Bay Rd # 106
Carolina Shores, NC 28467-2498
Phone
(910) 763-3601
Fax
(910) 763-4608
NPI assigned
Aug 31, 2015
Last updated
Oct 6, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1880 SC
Optometrist 152W00000X 2425 NC Primary

Addresses

Primary practice location

75 Emerson Bay Rd # 106
Carolina Shores, NC 28467-2498

Mailing address

75 Emerson Bay Rd # 106
Carolina Shores, NC 28467-2498
Phone (910) 763-3601

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
I20151023002062 NC Practitioner - Optometry 7618286121 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wilmington Eye, P.a.Group PAC ID 8921034323, 29 clinicians

Practice addresses (Care Compare)

1729 New Hanover Medical Park Dr
Wilmington, NC 28403-5345
Phone (910) 763-3601

Merit-based Incentive Payment System (MIPS)

Final score
89.61 of 100Reported as group
Quality
91.39
Promoting interoperability
100
Improvement activities
40
Cost
73.98

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2425NCMDClinical Psychologist
1880SCMDDental Hygienist

Practice roles

OrganizationSpecialtyStatusNew patients
J. Mark Saunders OD P a Optometrist CurrentSince Mar 28, 2019 Accepting new patients
Wilmington Eye, P.a. CurrentSince Aug 16, 2022 Accepting new patients
Wilmington Eye, P.a. CurrentSince Aug 16, 2022 Accepting new patients

Locations

75 Emerson Bay Rd
#106
Carolina Shores, NC 28467

75 Emerson Bay Rd
Ste 106
Carolina Shores, NC 28467

4637 Main St
South Brunswick, NC 28470
Phone (910) 754-9687

5211 Eason St
#1
Southport, NC 28461
Phone (910) 454-0563

1729 Medical Park
#P
Wilmington, NC 28403

1729 New Hanover Medical Park Dr
Wilmington, NC 28403
Phone (910) 772-8261

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • Direct secure messaging: jgreene@direct.eyecare-partners.com
  • Direct secure messaging: jgreene@wileye.intellechartdirect.net

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1440979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665014400000",
    "number": "1235506833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75 EMERSON BAY RD # 106",
            "city": "CAROLINA SHORES",
            "state": "NC",
            "postal_code": "284672498",
            "telephone_number": "910-763-3601",
            "fax_number": "910-763-4608"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 EMERSON BAY RD # 106",
            "city": "CAROLINA SHORES",
            "state": "NC",
            "postal_code": "284672498",
            "telephone_number": "910-763-3601",
            "fax_number": "910-763-4608"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREENE",
        "first_name": "JILL",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-31",
        "last_updated": "2022-10-06",
        "certification_date": "2022-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "SC",
            "license": "1880",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NC",
            "license": "2425",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carolina Shores, NC

Sources for this page

Verify at the official NPI Registry.