Active NPI
Eyecarecenter OD PA
- Optometrist
- Fayetteville, NC
National Provider Identifier
1366495772
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- Legal business name
- EYECARECENTER OD PA
- Practice address
- 579 Cross Creek Mall
Fayetteville, NC 28303-7245 - Phone
- (636) 200-4393
- Fax
- (910) 860-1954
- NPI assigned
- May 18, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Alison Bailey, OD
- Title
- Owner
- Phone
- (636) 200-4393
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | Primary |
Addresses
Primary practice location
579 Cross Creek Mall
Fayetteville, NC 28303-7245
Mailing address
PO Box 207261
Dallas, TX 75320-7261
Phone (636) 200-4393
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0208H | Other | NC | BCBSNC GROUP NUMBER |
| 890208H | Medicaid | NC | |
| CA8262 | Other | NC | RR MEDICARE GROUP |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NC
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040318001780 | NC | Part B Supplier - Clinic/Group Practice | 7315834462 |
Receives reassigned benefits from 137 practitioners 42 other NPIs on this enrollment This NPI is an additional NPI on the enrollment |
National Provider Directory
National Provider DirectoryOwnership & related parties
Other NPIs on the same Medicare enrollment 40
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Optometrist
- Fayetteville, NC
- NPI 1376586867
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147910400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1695945600000",
"number": "1366495772",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 207261",
"city": "DALLAS",
"state": "TX",
"postal_code": "753207261",
"telephone_number": "636-200-4393",
"fax_number": "636-527-0766"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "579 CROSS CREEK MALL",
"city": "FAYETTEVILLE",
"state": "NC",
"postal_code": "283037245",
"telephone_number": "636-200-4393",
"fax_number": "910-860-1954"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "EYECARECENTER OD PA",
"organizational_subpart": "NO",
"enumeration_date": "2006-05-18",
"last_updated": "2023-09-29",
"certification_date": "2023-09-29",
"status": "A",
"authorized_official_last_name": "BAILEY",
"authorized_official_first_name": "ALISON",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "636-200-4393",
"authorized_official_name_prefix": "Dr.",
"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": "BCBSNC GROUP NUMBER",
"identifier": "0208H",
"state": "NC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "890208H",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE GROUP",
"identifier": "CA8262",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Fayetteville, NC
- Extended Reach Daytreatment for Children and Adolescents
- Extended Reach Daytreatment for Childrena and Adolescents LLC
- Extensions of Living, L.L.C.
- Eye Medics Optometry PA
- Eye Tech Optical Inc
- Eyecarecenter, O.D., P.a.
- Eyecarecenter, O.D., P.a.
- Eyemart Expess LTD
- Eyemart Express LLC
- Ez Ryder Kreative Mobile Lifestyles Inc
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.