Individual provider Active NPI

Emily Ann Burgon, O.D.

  • Optometrist
  • Raleigh, NC
National Provider Identifier
1255776506
Registry record updated Oct 3, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3431 Issued in TN
Practice address
2024 Cameron St
Raleigh, NC 27605-1311
Phone
(919) 863-2015
Fax
(919) 861-0540
NPI assigned
Apr 30, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 3431 TN Primary
Optometrist 152W00000X 2340 NC

Addresses

Primary practice location

2024 Cameron St
Raleigh, NC 27605-1311

Mailing address

1950 Old Gallows Rd
Suite 520
Vienna, VA 22182-3990
Phone (703) 847-8899

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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
I20190110001715 TN Practitioner - Optometry 8224250675 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pennsylvania College of Optometry, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Vision Source of Hendersonville PLLCGroup PAC ID 4789766759, 3 clinicians
Look East PLLCGroup PAC ID 7810281359, 2 clinicians

Practice addresses (Care Compare)

100 Country Club Dr
Suite 106
Hendersonville, TN 37075-4099
Phone (615) 824-4246

966 Main St
Nashville, TN 37206-3614
Phone (615) 928-2281

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2340NCMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Essential Eye Care, PLLC Optometrist CurrentSince Aug 3, 2021 Accepting new patients
The Optical Shoppe PLLC Optometrist CurrentSince Sep 3, 2018 Accepting new patients
Look East PLLC Optometrist CurrentSince Jan 15, 2019 Accepting new patients
Music City Eye Care LLC Optometrist Current Accepting new patients
Music City Eye Care LLC Optometrist CurrentSince Jul 7, 2020 Accepting new patients
Music City Eye Care LLC Optometrist CurrentSince Jul 7, 2020 Accepting new patients
Vision Source of Hendersonville Optometrist CurrentSince Oct 3, 2018 Accepting new patients
Dr Paul D Trapeni Jr PastSince Sep 3, 2018 Accepting new patients

Locations

100 Country Club Dr
Hendersonville, TN 37075

100 Country Club Dr
Ste 106
Hendersonvlle, TN 37075
Phone (615) 818-4309

2012 Memorial Blvd
Murfreesboro, TN 37129
Phone (615) 203-5037

140 Joe B Jackson Pkwy
Murfreesboro, TN 37127
Phone (615) 203-9165

1524 Beasie Rd
Murfreesboro, TN 37128
Phone (615) 439-2641

966 Main St
Nashville, TN 37206
Phone (615) 928-2281

23 N Lowry St
Smyrna, TN 37167
Phone (615) 459-0675

Organizations & group practices 8

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": "1367280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1538524800000",
    "number": "1255776506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1950 OLD GALLOWS RD",
            "address_2": "SUITE 520",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221823990",
            "telephone_number": "703-847-8899",
            "fax_number": "703-991-0514"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2024 CAMERON ST",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276051311",
            "telephone_number": "919-863-2015",
            "fax_number": "919-861-0540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURGON",
        "first_name": "EMILY",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-04-30",
        "last_updated": "2018-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TN",
            "license": "3431",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NC",
            "license": "2340",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

Verify at the official NPI Registry.