Teri D Anderson, OD
Individual provider Active NPI Optometrist · Winston Salem, NC
NPI 1285676262 · NPPES record last updated Jul 20, 2011
Key facts
- NPI
- 1285676262
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Optometrist 152W00000X
- License
- 1742 (NC)
- Practice address
- 800 S Stratford Rd
Winston Salem, NC 27103-3202 - Phone
- (336) 765-5788
- Fax
- (336) 765-5584
- NPI assigned
- Jun 12, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 4
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NC
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20050426001400 | NC | Practitioner - Optometry | 2567401854 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1742 | NC | MD | Athletic Trainer |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Eyecarecenter OD PA | Optometrist | Current |
Accepting new patients |
| Eyecarecenter, O.D., P.a. | Optometrist | Current |
Accepting new patients |
| Eyecarecenter OD PA | Optometrist | Current | Accepting new patients |
| Eyecarecenter OD PA | Optometrist | Past | Accepting new patients |
Locations
1575 NC Highway 66 S
Kernersville, NC 27284
Phone (336) 933-8514
819 Tiffany Blvd
Rocky Mount, NC 27804
Phone (252) 972-2020
800 S Stratford Rd
Winston Salem, NC 27103
Phone (336) 765-5788
Interoperability endpoints
- tanderson@direct.eyecare-partners.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 1742 | NC | Yes |
Addresses
Primary practice location
800 S Stratford Rd
Winston Salem, NC 27103-3202
Mailing address
800 S Stratford Rd
Winston Salem, NC 27103-3202
Phone (336) 765-5788
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 09263 | Other | NC | BCBSNC PROVIDER ID |
| 8909263 | Medicaid | NC |
Other providers in Winston Salem, NC
- Ruth Frye Anderson
- Sarah Anderson
- Sean Robert Anderson
- Seth Ryan Anderson
- Susanne B Anderson
- Vivian Anderson
- Zachary Baise Anderson
- Zeynoire Deborah D'Nae Anderson
- Morgan Andrade
- Helen Kalim Andraos
All providers in Winston Salem, NC · Optometrist in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 20, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.