Individual provider Active NPI

Van S Romine, OD

  • Optometrist
  • Burlington, NC
National Provider Identifier
1427082791
Registry record updated Nov 19, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1214 Issued in NC
Practice address
1016 Kirkpatrick Road
Burlington, NC 27215-9714
Phone
(336) 228-0254
Fax
(336) 584-0101
NPI assigned
Jul 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1214 NC Primary

Addresses

Primary practice location

1016 Kirkpatrick Road
Burlington, NC 27215-9714

Mailing address

1016 Kirkpatrick Road
Burlington, NC 27215-9714
Phone (336) 228-0254

Other identifiers 1

IdentifierTypeStateIssuer
7909786MedicaidNC

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

Interoperability endpoints

  • Direct secure messaging: vromine@aec1872.srs-direct.com

NPI Registry JSON

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

{
    "created_epoch": "1152489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1258588800000",
    "number": "1427082791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1016 KIRKPATRICK ROAD",
            "city": "BURLINGTON",
            "state": "NC",
            "postal_code": "272159714",
            "telephone_number": "336-228-0254",
            "fax_number": "336-584-0101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1016 KIRKPATRICK ROAD",
            "city": "BURLINGTON",
            "state": "NC",
            "postal_code": "272159714",
            "telephone_number": "336-228-0254",
            "fax_number": "336-584-0101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROMINE",
        "first_name": "VAN",
        "middle_name": "S",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-10",
        "last_updated": "2009-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NC",
            "license": "1214",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7909786",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Burlington, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2009; 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.