Robert Edward Connelly, OPTOMETRIST

Primary specialty

OptometristTaxonomy code 152W00000X

License

1032 Issued in NC

Practice address

485 West St
Pittsboro, NC 27312-9533

Phone

(919) 542-2020

Fax

(919) 545-0922

NPI assigned

Jan 19, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in NC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

University of Alabama School of Medicine, 1980

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Pittsboro Family Eye Center

  • Optometrist
  • Pittsboro, NC
  • NPI 1750582052
  NPD (past) Authorized official

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

{
    "created_epoch": "1137628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1468195200000",
    "number": "1457331100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "485 WEST ST",
            "address_2": "PO BOX 1027",
            "city": "PITTSBORO",
            "state": "NC",
            "postal_code": "273129533",
            "telephone_number": "919-542-2020",
            "fax_number": "919-545-0922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "485 WEST ST",
            "city": "PITTSBORO",
            "state": "NC",
            "postal_code": "273129533",
            "telephone_number": "919-542-2020",
            "fax_number": "919-545-0922"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONNELLY",
        "first_name": "ROBERT",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "credential": "OPTOMETRIST",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-01-19",
        "last_updated": "2016-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NC",
            "license": "1032",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8909174",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "09174",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Laura A Collatz, DDS
• Ann M Collins, PA
• Rachel Collins
• Joseph Louis Colosimo II, MD
• Comprehensive Practice Resources Inc
• Heather Connors, LCAS
• Megan Patricia Cooper, MSW, LCSWJHUYYYHJUUU
• Courtney Nicole Copeland, ATC
• John D Corey, MD
• County of Chatham (Chatham County Health Department - Behavorial Health Services)

• Optometrist in Pittsboro, NC
• Providers in Pittsboro, NC by specialty
• Optometrist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.