NPIMap

Organization Active NPI

Roger W. Luck

  • Eyewear Supplier
  • Rockingham, NC
National Provider Identifier
1497945943
Registry record updated Jun 18, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Eyewear SupplierTaxonomy code 332H00000X
License
398 Issued in NC
Legal business name
ROGER W. LUCK
Practice address
211 W Broad Ave
Rockingham, NC 28379-3529
Phone
(910) 997-4949
NPI assigned
Jul 31, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2008

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

Authorized official

Name
Mr. Roger Wayne Luck, OPTICIANNPI 1386723237
Title
Owner
Phone
(910) 997-4949

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Eyewear Supplier 332H00000X 398 NC Primary

Addresses

Primary practice location

211 W Broad Ave
Rockingham, NC 28379-3529

Mailing address

211 W Broad Ave
Rockingham, NC 28379-3529
Phone (910) 997-4949

Other identifiers 3

IdentifierTypeStateIssuer
1234KOtherNCNC HEALTHCHOICE
Y1925OtherNCNC SERVICES FOR THE BLIND
8801757MedicaidNC

Other names 1

  • The Spec Shoppe Doing business as

National Provider Directory

National Provider Directory

Locations

211 W Broad Ave
Rockingham, NC 28379
Phone (910) 997-4949

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1185840000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213747200000",
    "number": "1497945943",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 W BROAD AVE",
            "city": "ROCKINGHAM",
            "state": "NC",
            "postal_code": "283793529",
            "telephone_number": "910-997-4949"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 W BROAD AVE",
            "city": "ROCKINGHAM",
            "state": "NC",
            "postal_code": "283793529",
            "telephone_number": "910-997-4949"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROGER W. LUCK",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-31",
        "last_updated": "2008-06-18",
        "status": "A",
        "authorized_official_last_name": "LUCK",
        "authorized_official_first_name": "ROGER",
        "authorized_official_middle_name": "WAYNE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "910-997-4949",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "OPTICIAN"
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "NC",
            "license": "398",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NC HEALTHCHOICE",
            "identifier": "1234K",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NC SERVICES FOR THE BLIND",
            "identifier": "Y1925",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8801757",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Spec Shoppe",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Rockingham, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2008; 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.