Yadkin Vision Center O.D., PLLC

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

YADKIN VISION CENTER O.D., PLLC

Practice address

225 E Lee Ave
Yadkinville, NC 27055-8227

Phone

(336) 679-2931

Fax

(336) 677-6486

NPI assigned

Oct 31, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Scott Gordon, O.D.NPI 1598723934

Title

Member/Manager

Phone

(336) 679-2931

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Yadkin Vision Center O.D., PLLC

  • Optometrist
  • East Bend, NC
  • NPI 1932353976

  O20090128000016

  Same enrollment

Locations

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Scott David Gordon, O.D.

  • Optometrist
  • Yadkinville, NC
  • NPI 1598723934
  Medicare reassignment Care Compare group NPD Authorized official
• Gail C Gordon, O.D.

  • Optometrist
  • Yadkinville, NC
  • NPI 1417940552
  Medicare reassignment Care Compare group NPD
• Andrew Humiston, OD

  • Optometrist
  • Yadkinville, NC
  • NPI 1790485100
  Medicare reassignment Care Compare group NPD
• Charles Brian Jay, OD

  • Optometrist
  • Yadkinville, NC
  • NPI 1659860187
  Medicare reassignment Care Compare group NPD
• Danielle Elaine Jordan, O.D.

  • Optometrist
  • Dobson, NC
  • NPI 1386945699
  NPD (past)
• Jeffrey Reile Bryson Tarr, O.D.

  • Optometrist
  • Advance, NC
  • NPI 1154654127
  NPD (past)

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

{
    "created_epoch": "1225411200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1620259200000",
    "number": "1487807616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 E LEE AVE",
            "city": "YADKINVILLE",
            "state": "NC",
            "postal_code": "270558227",
            "telephone_number": "336-679-2931",
            "fax_number": "336-677-6486"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 E LEE AVE",
            "city": "YADKINVILLE",
            "state": "NC",
            "postal_code": "270558227",
            "telephone_number": "336-679-2931",
            "fax_number": "336-677-6486"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "115 Pauline St",
            "address_purpose": "LOCATION",
            "city": "East Bend",
            "state": "NC",
            "postal_code": "270187686",
            "country_code": "US",
            "telephone_number": "336-699-8170",
            "fax_number": "336-699-8162",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "YADKIN VISION CENTER O.D., PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-31",
        "last_updated": "2021-05-06",
        "certification_date": "2021-05-06",
        "status": "A",
        "authorized_official_last_name": "GORDON",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_title_or_position": "MEMBER/MANAGER",
        "authorized_official_telephone_number": "336-679-2931",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5950718",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Yadkin Dialysis Center of Wake Forest University (Yadkin Dialysis Center)
• Yadkin Nursing Care Center, Inc. (The Magnolias Over Yadkin)
• Yadkin Nursing Care Center, Inc.
• Yadkin Physical Therapy, L.L.C.
• Yadkin Senior Services, Inc.
• Yadkin Vision Center, OD PA
• Yadkinville Chiropractic Center
• Yadkinville Chiropractic DC PA
• Susan B Yuson, MD
• Jerry Thomas Ziglar, MD

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2021; 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.