Individual provider Active NPI

Benjamin McCray Taylor, OD

  • Optometrist
  • Wilmington, NC
National Provider Identifier
1235788795
Registry record updated Dec 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2591 Issued in NC
Practice address
1613 Military Cutoff Rd Ste 230
Wilmington, NC 28403-5745
Phone
(910) 256-6364
NPI assigned
Sep 8, 2019
Last updated
Dec 9, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2591 NC Primary

Addresses

Primary practice location

1613 Military Cutoff Rd Ste 230
Wilmington, NC 28403-5745

Mailing address

1613 Military Cutoff Rd Ste 230
Wilmington, NC 28403-5745

Other practice location 1

16150 Hwy 17 N
Ste A
Hampstead, NC 28443
Phone (910) 270-2800

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
I20191021002408 NC Practitioner - Optometry 6103158324 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Edward L. Paul, Jr., O.D., PH.D., P.a.Group PAC ID 0941309892, 5 clinicians

Practice addresses (Care Compare)

1613 Military Cutoff Rd
Suite 230
Wilmington, NC 28403-5745
Phone (910) 256-6364

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2591NCMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Edward L. Paul, Jr., O.D., PH.D., P.a. Optometrist CurrentSince May 1, 2021 Accepting new patients
Myeyedr Optometry of North Carolina, PLLC Optometrist CurrentSince Sep 3, 2019 Accepting new patients
Myeyedr Optometry of North Carolina, PLLC Optometrist Current Accepting new patients
Brad Hearn OD PA Optometrist CurrentSince Sep 28, 2022 Accepting new patients
Myeyedr Optometry of North Carolina, PLLC Optometrist CurrentSince Sep 3, 2019 Accepting new patients
Brad Hearn OD PA Optometrist CurrentSince Jul 24, 2022 Accepting new patients

Locations

1960 Randolph Rd
Charlotte, NC 28207
Phone (704) 372-5332

1003 Vandora Springs Rd
Garner, NC 27529
Phone (919) 772-4575

16150 US Highway 17
Ste A
Hampstead, NC 28443
Phone (910) 270-2800

16525 Birkdale Commons Pkwy
Ste 100
Huntersville, NC 28078
Phone (704) 896-3311

1613 Military Cutoff Rd
Ste 230
Wilmington, NC 28403
Phone (910) 256-6364

201 Racine Dr
Wilmington, NC 28403
Phone (910) 395-6050

1950 Old Gallows Rd
Ste 520
Vienna, VA 22182

8614 Westwood Center Dr
Fl 9
Vienna, VA 22182

Organizations & group practices 6

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": "1567900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670544000000",
    "number": "1235788795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1613 MILITARY CUTOFF RD STE 230",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284035745"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1613 MILITARY CUTOFF RD STE 230",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284035745",
            "telephone_number": "910-256-6364"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "16150 Hwy 17 N",
            "address_2": "Ste A",
            "address_purpose": "LOCATION",
            "city": "Hampstead",
            "state": "NC",
            "postal_code": "28443",
            "country_code": "US",
            "telephone_number": "910-270-2800",
            "fax_number": "910-270-9100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TAYLOR",
        "first_name": "BENJAMIN",
        "middle_name": "MCCRAY",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-09-08",
        "last_updated": "2022-12-09",
        "certification_date": "2022-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NC",
            "license": "2591",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, NC

Sources for this page

Verify at the official NPI Registry.