Optometric Eye Clinic, P.a.

Primary specialty

OptometristTaxonomy code 152W00000X

License

1130 Issued in NC

Legal business name

OPTOMETRIC EYE CLINIC, P.A.

Practice address

622 N Main St
Mooresville, NC 28115-2312

Phone

(704) 664-5406

Fax

(704) 663-6498

NPI assigned

Jan 11, 2011

Organization subpart

No

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

Authorized official

Name

Peggy Lynn Wike, O.D.NPI 1386643757

Title

Optometrist

Phone

(704) 664-5406

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NC2 enrollments

Enrollment records 2

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Peggy Lynn Wike, O.D.

  • Optometrist
  • Mooresville, NC
  • NPI 1386643757
  Medicare reassignment NPD Authorized official
• William Harrison, OD

  • Optometrist
  • Boone, NC
  • NPI 1851152755
  Medicare reassignment NPD

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

{
    "created_epoch": "1294704000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727654400000",
    "number": "1295030989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "622 N MAIN ST",
            "city": "MOORESVILLE",
            "state": "NC",
            "postal_code": "281152312",
            "telephone_number": "704-664-5406",
            "fax_number": "704-663-6498"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "622 N MAIN ST",
            "city": "MOORESVILLE",
            "state": "NC",
            "postal_code": "281152312",
            "telephone_number": "704-664-5406",
            "fax_number": "704-663-6498"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPTOMETRIC EYE CLINIC, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-01-11",
        "last_updated": "2024-09-30",
        "certification_date": "2024-09-30",
        "status": "A",
        "authorized_official_last_name": "WIKE",
        "authorized_official_first_name": "PEGGY",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "704-664-5406",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "NC",
            "license": "1130",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kayla W Oldenkamp
• Donna Barbaglia Olsen, D.M.D.
• Richard Allen Olsen, D.D.S
• Tiffany Olsen
• Jennifer Onsrud, PHARMD
• Kimberly Kathryn Orellana
• Ashley Oriol, MSW, LCSW
• Stephanie Lee Ormand, OTR L
• Ashley Patricia Orourke, PT, DPT, ATC, LAT
• Orthocarolina

• Optometrist in Mooresville, NC
• Providers in Mooresville, NC by specialty
• Optometrist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.