NPIMap

Organization Active NPI

Eyecarecenter OD PA

  • Optometrist
  • Wilson, NC
National Provider Identifier
1376582239
Registry record updated Sep 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
EYECARECENTER OD PA
Practice address
3401B Raleigh Road Pkwy W
Wilson, NC 27896-8217
Phone
(252) 291-0767
Fax
(252) 291-0921
NPI assigned
Jun 6, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2023

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

Addresses

Primary practice location

3401B Raleigh Road Pkwy W
Wilson, NC 27896-8217

Mailing address

PO Box 207261
Dallas, TX 75320-7261
Phone (636) 200-4393

Other identifiers 3

IdentifierTypeStateIssuer
8909165MedicaidNC
CA8262OtherNCRR MEDICARE GROUP
09165OtherNYBCBSNC GROUP NUMBER

Other names 1

  • Optometric Eye Care Center OD PA Former legal business name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
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

Other NPIs on the same Medicare enrollment 40

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 40

National Provider Directory

National Provider Directory

Locations

3001 Raleigh Road Pkwy W
Wilson, NC 27896
Phone (252) 291-0767

3001 Raleigh Rd W
Wilson, NC 27896
Phone (252) 291-0767

Practitioners & affiliated clinicians

Practitioners 31

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

View all 31

NPI Registry JSON

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

{
    "created_epoch": "1149552000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1695945600000",
    "number": "1376582239",
    "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": "636-527-0799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3401B RALEIGH ROAD PKWY W",
            "city": "WILSON",
            "state": "NC",
            "postal_code": "278968217",
            "telephone_number": "252-291-0767",
            "fax_number": "252-291-0921"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYECARECENTER OD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-06",
        "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": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8909165",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE GROUP",
            "identifier": "CA8262",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSNC GROUP NUMBER",
            "identifier": "09165",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Optometric Eye Care Center OD PA",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Optometric Eye Care Center OD PA",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Wilson, NC

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.

Verify at the official NPI Registry.