NPIMap

Organization Active NPI

Wilcox Optometry PLLC

  • Optometrist
  • Rocky Mount, NC
National Provider Identifier
1407529696
Registry record updated Jul 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
WILCOX OPTOMETRY PLLC
Practice address
800 Tiffany Blvd Ste 101
Rocky Mount, NC 27804-1807
Phone
(502) 244-2420
Fax
(502) 996-8282
NPI assigned
Jul 26, 2021
Last updated
Jul 27, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2021

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

Authorized official

Name
Jennifer M Wilcox, OD
Title
Owner
Phone
(404) 434-6415

Specialties & licenses 1

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

Addresses

Primary practice location

800 Tiffany Blvd Ste 101
Rocky Mount, NC 27804-1807

Mailing address

12910 Shelbyville Rd Ste 300
Louisville, KY 40243-2404
Phone (502) 813-4415

Other practice location 1

2214 Van Aken Cir
Shelby, NC 28150-9716
Phone (502) 244-2420 ext. 5415

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210802002357 NC Part B Supplier - Clinic/Group Practice 9234533092 Receives reassigned benefits from 15 practitioners
Practice locations: Rocky Mount, NC

National Provider Directory

National Provider Directory

Locations

327 Hillsborough St
Raleigh, NC 27603

Practitioners & affiliated clinicians

Practitioners 17

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1627257600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1627344000000",
    "number": "1407529696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12910 SHELBYVILLE RD STE 300",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402432404",
            "telephone_number": "502-813-4415",
            "fax_number": "502-996-8282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 TIFFANY BLVD STE 101",
            "city": "ROCKY MOUNT",
            "state": "NC",
            "postal_code": "278041807",
            "telephone_number": "502-244-2420",
            "fax_number": "502-996-8282"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2214 Van Aken Cir",
            "address_purpose": "LOCATION",
            "city": "Shelby",
            "state": "NC",
            "postal_code": "281509716",
            "country_code": "US",
            "telephone_number": "502-244-2420 x5415",
            "fax_number": "502-996-8282",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "WILCOX OPTOMETRY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-26",
        "last_updated": "2021-07-27",
        "certification_date": "2021-07-27",
        "status": "A",
        "authorized_official_last_name": "WILCOX",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "404-434-6415",
        "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 Rocky Mount, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2021; 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.