Individual provider Active NPI

Teri D Anderson, OD

  • Optometrist
  • Winston Salem, NC
National Provider Identifier
1285676262
Registry record updated Jul 20, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1742 Issued in 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
Last updated
Jul 20, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1742 NC Primary

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

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
I20050426001400 NC Practitioner - Optometry 2567401854 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1742NCMDHearing Instrument Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Eyecarecenter, O.D., P.a. Optometrist CurrentSince Feb 15, 2010 Accepting new patients
Eyecarecenter OD PA Optometrist CurrentSince Feb 15, 2010 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

  • Direct secure messaging: tanderson@direct.eyecare-partners.com

Organizations & group practices 4

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": "1150070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1311120000000",
    "number": "1285676262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 S STRATFORD RD",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271033202",
            "telephone_number": "336-765-5788",
            "fax_number": "336-765-5584"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 S STRATFORD RD",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271033202",
            "telephone_number": "336-765-5788",
            "fax_number": "336-765-5584"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "TERI",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-12",
        "last_updated": "2011-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NC",
            "license": "1742",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winston Salem, NC

Sources for this page

Verify at the official NPI Registry.