Eye Care Associates OD PA

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

EYE CARE ASSOCIATES OD PA

Practice address

1001 Wide Waters Pkwy
Knightdale, NC 27545-7333

Phone

(919) 861-2020

Fax

(919) 277-0854

NPI assigned

May 2, 2006

Organization subpart

No

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

Authorized official

Name

Stephen Bolick, OD

Title

Ceo

Phone

(919) 847-0187

Specialties & licenses 1

Addresses

Other identifiers 3

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

{
    "created_epoch": "1146528000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1360540800000",
    "number": "1306804232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7100 SIX FORKS RD",
            "address_2": "SUITE 301",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276156156",
            "telephone_number": "919-847-0187",
            "fax_number": "919-676-2231"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 WIDE WATERS PKWY",
            "city": "KNIGHTDALE",
            "state": "NC",
            "postal_code": "275457333",
            "telephone_number": "919-861-2020",
            "fax_number": "919-277-0854"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYE CARE ASSOCIATES OD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-02",
        "last_updated": "2013-02-11",
        "status": "A",
        "authorized_official_last_name": "BOLICK",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "919-847-0187",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CK2419",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS",
            "identifier": "016PE",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89016PE",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.