Piedmont Ophthalmology Clinic Inc

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

Legal business name

PIEDMONT OPHTHALMOLOGY CLINIC INC

Doing business as

Dominion Eye Center

Practice address

746 NE Jensen Beach Blvd
Jensen Beach, FL 34957-4754

Phone

(434) 250-6270

NPI assigned

Aug 24, 2006

Last updated

Mar 24, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Melissa H Gammon

Title

Practice Manager

Phone

(434) 799-3232

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Dominion Eye Center Doing business as

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Piedmont Ophthalmology Clinic, Inc

  dba Dominion Eye Center

  • Optometrist
  • Danville, VA
  • NPI 1255365573

  Member Of

  NPD member

Locations

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

{
    "created_epoch": "1156377600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1616544000000",
    "number": "1245347327",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "746 NE JENSEN BEACH BLVD",
            "city": "JENSEN BEACH",
            "state": "FL",
            "postal_code": "349574754",
            "telephone_number": "434-250-6270"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "746 NE JENSEN BEACH BLVD",
            "city": "JENSEN BEACH",
            "state": "FL",
            "postal_code": "349574754",
            "telephone_number": "434-250-6270"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PIEDMONT OPHTHALMOLOGY CLINIC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-24",
        "last_updated": "2021-03-24",
        "certification_date": "2021-03-24",
        "status": "A",
        "authorized_official_last_name": "GAMMON",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "434-799-3232",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS ANTHEM",
            "identifier": "080168",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dominion Eye Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Dominion Eye Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Ryanne Renee Petrof, SLP
• Maura Elizabeth Petrulsky
• Regina M Phillips
• Physical Therapy for Health LLC
• Physicians Immediate Care Jensen Beach, LLC
• Marie Pierre-Canel
• Playful Progress LLC
• Christina Ann Porto, BS
• Portside Spine & Wellness LLC
• Maria Cristina Posse

• Ophthalmology Physician in Jensen Beach, FL
• Providers in Jensen Beach, FL by specialty
• Ophthalmology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.