Active NPI
William Jeffery Miller
- Optometrist
- Winston Salem, NC
National Provider Identifier
1417014937
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 840
- Practice address
- 2910 Reynolda Rd
Winston Salem, NC 27106 - Phone
- (336) 724-5000
- Fax
- (336) 723-3341
- NPI assigned
- Jan 3, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 840 | NC | Primary |
Addresses
Primary practice location
2910 Reynolda Rd
Winston Salem, NC 27106
Mailing address
2910 Reynolda Rd
Winston Salem, NC 27106
Phone (336) 724-5000
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8909618 | Medicaid | NC |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167782400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1346716800000",
"number": "1417014937",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2910 REYNOLDA RD",
"city": "WINSTON SALEM",
"state": "NC",
"postal_code": "27106",
"telephone_number": "336-724-5000",
"fax_number": "336-723-3341"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2910 REYNOLDA RD",
"city": "WINSTON SALEM",
"state": "NC",
"postal_code": "27106",
"telephone_number": "336-724-5000",
"fax_number": "336-723-3341"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MILLER",
"first_name": "WILLIAM",
"middle_name": "JEFFERY",
"name_prefix": "Dr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-01-03",
"last_updated": "2012-09-04",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "NC",
"license": "840",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8909618",
"state": "NC"
}
],
"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 4, 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.