NPIMap

Organization Active NPI

Eyecarecenter OD PA

  • Optometrist
  • Winston Salem, NC
National Provider Identifier
1427599802
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
2630 Peters Creek Pkwy
Winston Salem, NC 27127-5655
Phone
(636) 200-4393
Fax
(336) 785-3002
NPI assigned
Mar 17, 2017
Last updated
Sep 29, 2023By the provider in NPPES
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, ODNPI 1043214844
Title
Owner
Phone
(636) 200-4393

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X NC Primary

Addresses

Primary practice location

2630 Peters Creek Pkwy
Winston Salem, NC 27127-5655

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
0222680041OtherNCSUPPLIER NUMBER

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170622002763 NC Part B Supplier - Clinic/Group Practice 7315834462 Receives reassigned benefits from 26 practitioners
Practice locations: Winston Salem, NC

Other NPIs with the same Medicare PAC ID 3

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 27

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 27

NPI Registry JSON

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

{
    "created_epoch": "1489708800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1695945600000",
    "number": "1427599802",
    "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": "636-527-0766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2630 PETERS CREEK PKWY",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271275655",
            "telephone_number": "636-200-4393",
            "fax_number": "336-785-3002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYECARECENTER OD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-17",
        "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": "",
            "desc": "Optometrist",
            "state": "NC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SUPPLIER NUMBER",
            "identifier": "0222680041",
            "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 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.