Individual provider Active NPI

David Morgan Reynolds, OD

  • Optometrist
  • Kernersville, NC
National Provider Identifier
1316905722
Registry record updated Jan 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1554 Issued in NC
Practice address
1027 S Main St
Kernersville, NC 27284-8186
Phone
(336) 996-2020
Fax
(336) 996-8860
NPI assigned
May 3, 2006
Last updated
Jan 21, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1554 NC Primary

Addresses

Primary practice location

1027 S Main St
Kernersville, NC 27284-8186

Mailing address

1950 Old Gallows Rd Ste 520
Vienna, VA 22182-3970

Other identifiers 5

IdentifierTypeStateIssuer
44039OtherDAVIS
118179OtherEYEMED
89093G3MedicaidNC
26522OtherSPECTERA
093G3OtherNCBCBS NC

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
I20070118000465 NC Practitioner - Optometry 9537160593 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of Houston - College of Optometry, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

3354 W Friendly Ave
Greensboro, NC 27410-4888
Phone (336) 387-0930

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1554NCMDAnatomic Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Myeyedr Optometry of North Carolina, PLLC Optometrist Current Accepting new patients
Myeyedr Optometry of North Carolina, PLLC Optometrist CurrentSince Nov 2, 2021 Accepting new patients
Myeyedr Optometry of North Carolina, PLLC Optometrist CurrentSince Nov 2, 2021 Accepting new patients
David M Reynolds OD PC Optometrist CurrentSince Jul 5, 2006 Accepting new patients
Myeyedr Optometry of North Carolina Optometrist Past Accepting new patients
Precision Eye Center, OD, PLLC Optometrist PastSince Jan 4, 2017 Accepting new patients
Myeyedr Optometry of North Carolina, PLLC Optometrist Past Accepting new patients

Locations

1201 Raleigh Rd
Ste E
Chapel Hill, NC 27517
Phone (919) 851-0093

1823 E Arbors Dr
Ste 325
Charlotte, NC 28262
Phone (704) 971-5000

1960 Randolph Rd
Charlotte, NC 28207
Phone (704) 372-5332

584 Church St N
Concord, NC 28025
Phone (704) 782-0677

789 Concord Pkwy N
Concord, NC 28027
Phone (704) 788-3333

19900 W Catawba Ave
Cornelius, NC 28031
Phone (704) 892-1000

3354 W Friendly Ave
Greensboro, NC 27410
Phone (336) 387-0930

9918 Knockando Ln
Ste 140
Huntersville, NC 28078
Phone (704) 237-3910

1027 S Main St
Kernersville, NC 27284
Phone (336) 996-2020

1729 Davie Ave
Statesville, NC 28677
Phone (704) 873-0524

1950 Old Gallows Rd
Ste 520
Vienna, VA 22182

8614 Westwood Center Dr
Fl 9
Vienna, VA 22182

Organizations & group practices 7

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": "1146614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642723200000",
    "number": "1316905722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1950 OLD GALLOWS RD STE 520",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221823970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1027 S MAIN ST",
            "city": "KERNERSVILLE",
            "state": "NC",
            "postal_code": "272848186",
            "telephone_number": "336-996-2020",
            "fax_number": "336-996-8860"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYNOLDS",
        "first_name": "DAVID",
        "middle_name": "MORGAN",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-03",
        "last_updated": "2022-01-21",
        "certification_date": "2022-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NC",
            "license": "1554",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DAVIS",
            "identifier": "44039",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EYEMED",
            "identifier": "118179",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89093G3",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SPECTERA",
            "identifier": "26522",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS NC",
            "identifier": "093G3",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kernersville, NC

Sources for this page

Verify at the official NPI Registry.