Coastal Eyes of the Outer Banks PLLC

Primary specialty

OptometristTaxonomy code 152W00000X

License

2015-00049 Issued in NC

Legal business name

COASTAL EYES OF THE OUTER BANKS PLLC

Practice address

112 W Wood Hill Dr
Nags Head, NC 27959-9394

Phone

(252) 489-5829

Fax

(252) 715-3446

NPI assigned

Nov 30, 2016

Last updated

Apr 19, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Amos Johns Willis, MDNPI 1528062015

Title

Physician

Phone

(252) 489-5829

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Amos J Willis, M.D.

  • Ophthalmology Physician
  • Nags Head, NC
  • NPI 1528062015

  Single Specialty

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1480464000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1713484800000",
    "number": "1508309188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 W WOOD HILL DR # 328",
            "city": "NAGS HEAD",
            "state": "NC",
            "postal_code": "279599394",
            "telephone_number": "252-489-5829"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 W WOOD HILL DR",
            "city": "NAGS HEAD",
            "state": "NC",
            "postal_code": "279599394",
            "telephone_number": "252-489-5829",
            "fax_number": "252-715-3446"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COASTAL EYES OF THE OUTER BANKS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-11-30",
        "last_updated": "2024-04-19",
        "certification_date": "2024-04-19",
        "status": "A",
        "authorized_official_last_name": "WILLIS",
        "authorized_official_first_name": "AMOS",
        "authorized_official_middle_name": "JOHNS",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "252-489-5829",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NC",
            "license": "2015-00049",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• CNC/Access Inc
• CNC/Access Inc
• CNC/Access, Inc.
• CNC/Access, Inc.
• CNC/Access, Inc.
• Christine Coleman, NP
• Community Care Clinic of Dare
• Community Care Clinic of Dare
• Continuum II Home Health & Hospice, Inc. (Continuum Home Care of Outer Banks)
• Croatan Family Medicine, P.C.

• Optometrist in Nags Head, NC
• Providers in Nags Head, NC by specialty
• Optometrist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2024; 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.