Organization Active NPI

Premier Vision Optometry

  • Optometrist
  • Winston Salem, NC
National Provider Identifier
1366313207
Registry record updated Sep 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
PREMIER VISION OPTOMETRY
Practice address
1040 Hanes Mall Blvd
Winston Salem, NC 27103-1309
Phone
(803) 322-6410
NPI assigned
Sep 15, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2025

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

Authorized official

Name
Marquavia Sha'Mia Stinson, ODNPI 1366055105
Title
Optometrist
Phone
(803) 322-6410

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X Primary

Addresses

Primary practice location

1040 Hanes Mall Blvd
Winston Salem, NC 27103-1309

Mailing address

331 White St E Ste 200
Rock Hill, SC 29730-5331

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1757894400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757894400000",
    "number": "1366313207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "331 WHITE ST E STE 200",
            "city": "ROCK HILL",
            "state": "SC",
            "postal_code": "297305331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1040 HANES MALL BLVD",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271031309",
            "telephone_number": "803-322-6410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER VISION OPTOMETRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-09-15",
        "last_updated": "2025-09-15",
        "certification_date": "2025-09-15",
        "status": "A",
        "authorized_official_last_name": "STINSON",
        "authorized_official_first_name": "MARQUAVIA",
        "authorized_official_middle_name": "SHA'MIA",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "803-322-6410",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winston Salem, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2025; 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.