Primary Vision Care Center, O.D., P.a.

Primary specialty

OptometristTaxonomy code 152W00000X

License

1127 Issued in NC

Legal business name

PRIMARY VISION CARE CENTER, O.D., P.A.

Practice address

13520 NC Hwy 50
Surf City, NC 28445

Phone

(910) 803-0555

Fax

(910) 338-3160

NPI assigned

May 22, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Phillip Carl Tart, O.D.NPI 1962698274

Title

President

Phone

(910) 803-0555

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Locations

Practitioners 4

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

• Phillip Carl Tart, O.D.

  • Optometrist
  • Surf City, NC
  • NPI 1962698274

  NC, Optometrist

  Medicare reassignment NPD Authorized official
• Kimberly L Bowers, O.D.

  • Optometrist
  • Garner, NC
  • NPI 1437293743
  NPD (past)
• John Michael Howard, OD

  • Optometrist
  • Southport, NC
  • NPI 1346289014
  NPD (past)
• Thomas R. Kirby, OD

  • Optometrist
  • Whiteville, NC
  • NPI 1265484737
  NPD (past)

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

{
    "created_epoch": "1179792000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1377648000000",
    "number": "1497964787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2429",
            "city": "SURF CITY",
            "state": "NC",
            "postal_code": "284432149",
            "telephone_number": "910-803-0555",
            "fax_number": "910-338-3160"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13520 NC HWY 50",
            "city": "SURF CITY",
            "state": "NC",
            "postal_code": "28445",
            "telephone_number": "910-803-0555",
            "fax_number": "910-338-3160"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIMARY VISION CARE CENTER, O.D., P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-22",
        "last_updated": "2013-08-28",
        "status": "A",
        "authorized_official_last_name": "TART",
        "authorized_official_first_name": "PHILLIP",
        "authorized_official_middle_name": "CARL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "910-803-0555",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "NC",
            "license": "1127",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTH CARE",
            "identifier": "2200320",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8909890",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "09890",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• All providers in Surf City, NC
• Optometrist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2013; 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.