Individual provider Active NPI

Clayton Davis, O.D.

  • Optometrist
  • Greenville, NC
National Provider Identifier
1487641825
Registry record updated Jan 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2454 Issued in NC
Practice address
210 SW Greenville Blvd
Greenville, NC 27834-6908
Phone
(252) 355-2441
NPI assigned
Sep 30, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 29, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 5803TG TX
Optometrist 152W00000X 590 NM
Optometrist 152W00000X 1870 SC
Optometrist 152W00000X 2454 NC Primary

Addresses

Primary practice location

210 SW Greenville Blvd
Greenville, NC 27834-6908

Mailing address

4441 Six Forks Rd Ste 106-366
Raleigh, NC 27609-5729

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20191202002785 NC Practitioner - Optometry 4880598200 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2454NCMDMarriage & Family Therapist
590NMMDAthletic Trainer
1870SCMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
The Eye Center, Doctors of Optometry, P.a. Optometrist CurrentSince Sep 21, 2019 Accepting new patients

Locations

6910 Fayetteville Rd
Ste 296
Durham, NC 27713
Phone (919) 361-9488

302 Cross CRK Mall
Fayetteville, NC 28303
Phone (910) 867-4466

4351 The Cir At North Hills St
Ste 107
Raleigh, NC 27609
Phone (919) 782-9091

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1128038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706486400000",
    "number": "1487641825",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4441 SIX FORKS RD STE 106-366",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276095729"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 SW GREENVILLE BLVD",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278346908",
            "telephone_number": "252-355-2441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "CLAYTON",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-09-30",
        "last_updated": "2024-01-29",
        "certification_date": "2024-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "5803TG",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NM",
            "license": "590",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "SC",
            "license": "1870",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NC",
            "license": "2454",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, NC

Sources for this page

Verify at the official NPI Registry.