Active NPI
Cynthia O Donnelly, OD
- Optometrist
- Burlington, NC
National Provider Identifier
1255361291
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 1184
- Practice address
- 1016 Kirkpatrick Road
Burlington, NC 27215-9714 - Phone
- (336) 228-0254
- Fax
- (336) 584-0101
- NPI assigned
- Jul 4, 2006
- Last updated
- Nov 19, 2009
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 1184 | NC | Primary |
Addresses
Primary practice location
1016 Kirkpatrick Road
Burlington, NC 27215-9714
Mailing address
1016 Kirkpatrick Road
Burlington, NC 27215-9714
Phone (336) 228-0254
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8909264 | Medicaid | NC |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1184 | NC | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151971200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1258588800000",
"number": "1255361291",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1016 KIRKPATRICK ROAD",
"city": "BURLINGTON",
"state": "NC",
"postal_code": "272159714",
"telephone_number": "336-228-0254",
"fax_number": "336-584-0101"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1016 KIRKPATRICK ROAD",
"city": "BURLINGTON",
"state": "NC",
"postal_code": "272159714",
"telephone_number": "336-228-0254",
"fax_number": "336-584-0101"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DONNELLY",
"first_name": "CYNTHIA",
"middle_name": "O",
"credential": "OD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-04",
"last_updated": "2009-11-19",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "NC",
"license": "1184",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8909264",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Burlington, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 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.