J Grady Elliott, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

1456 Issued in NC

Practice address

3111 Maplewood Ave
Suite 103
Winston Salem, NC 27103-3906

Phone

(336) 765-8130

Fax

(336) 765-6403

NPI assigned

Feb 8, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

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

Specialty

Optometry

Education

Southern College of Optometry, 1992

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Wake Forest University Health SciencesGroup PAC ID 4486564952, 2,633 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

99.15 of 100Reported as group

Promoting interoperability

99

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jelliott2907934@carolinashealthcaresystem.direct-ci.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Wake Forest University Health Sciences

  • Multi-Specialty Clinic/Center
  • Winston Salem, NC
  • NPI 1003803032
  Medicare reassignment Care Compare group NPD
• Clark Optometric Center PA

  • Optometrist
  • Durham, NC
  • NPI 1588619217
  Medicare reassignment NPD
• Pediatric Ophthalmology Associates, P.a.

  • Ophthalmology Physician
  • Greensboro, NC
  • NPI 1821239971
  NPD (past)
• Wake Forest University Health Sciences

  • Ophthalmology Physician
  • Greensboro, NC
  • NPI 1225139249
  NPD (past)
• Wake Forest University Health Sciences

  • Multi-Specialty Clinic/Center
  • Lexington, NC
  • NPI 1639454499
  NPD (past)

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

{
    "created_epoch": "1170892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1302652800000",
    "number": "1285774166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3111 MAPLEWOOD AVE",
            "address_2": "SUITE 103",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271033906",
            "telephone_number": "336-765-8130",
            "fax_number": "336-765-6403"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3111 MAPLEWOOD AVE",
            "address_2": "SUITE 103",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271033906",
            "telephone_number": "336-765-8130",
            "fax_number": "336-765-6403"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIOTT",
        "first_name": "J GRADY",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-08",
        "last_updated": "2011-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NC",
            "license": "1456",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0112W",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PALMETTO GBA",
            "identifier": "0247000001",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "890908B",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Abigail Layton Ellington, MD
• Terry W Ellington, O.D.
• Aaron R Elliott, CRNA
• Amy Elliott, M.ED.,CCC-SLP
• Erin Leigh Elliott, MS, LCMHCA
• Kathleen Marilyn Elliott, MD
• Kelly Kaitlin Elliott, DPM
• Larry Eugene Elliott, RPH
• Mary Elliott
• Mary Jane Elliott, PH.D.

• Optometrist in Winston Salem, NC
• Providers in Winston Salem, NC by specialty
• Optometrist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.