NPIMap

Organization Active NPI

Retina Institute of North Carolina PC

  • Ophthalmology Physician
  • Smithfield, NC
National Provider Identifier
1407110448
Registry record updated Jun 25, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
200600726 Issued in NC
Legal business name
RETINA INSTITUTE OF NORTH CAROLINA PC
Practice address
1535 E Booker Dairy Rd
Smithfield, NC 27577-9472
Phone
(919) 787-8555
Fax
(919) 787-8112
NPI assigned
Jun 25, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2012

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

Authorized official

Name
Lisa Fogel, M.D.
Title
Owner
Phone
(919) 787-8555

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207W00000X 200600726 NC Primary

Addresses

Primary practice location

1535 E Booker Dairy Rd
Smithfield, NC 27577-9472

Mailing address

2605 Blue Ridge Rd
Suite 220
Raleigh, NC 27607-6475
Phone (919) 787-8555

National Provider Directory

National Provider Directory
Tax ID family
Retina Institute of North Carolina3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1340582400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1340582400000",
    "number": "1407110448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2605 BLUE RIDGE RD",
            "address_2": "SUITE 220",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276076475",
            "telephone_number": "919-787-8555",
            "fax_number": "919-787-8112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1535 E BOOKER DAIRY RD",
            "city": "SMITHFIELD",
            "state": "NC",
            "postal_code": "275779472",
            "telephone_number": "919-787-8555",
            "fax_number": "919-787-8112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RETINA INSTITUTE OF NORTH CAROLINA PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-06-25",
        "last_updated": "2012-06-25",
        "status": "A",
        "authorized_official_last_name": "FOGEL",
        "authorized_official_first_name": "LISA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "919-787-8555",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "NC",
            "license": "200600726",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Smithfield, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2012; 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.