Organization Active NPI

Duplin Eye Associates PA

  • Optometrist
  • Kenansville, NC
National Provider Identifier
1508845587
Registry record updated Feb 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
DUPLIN EYE ASSOCIATES PA
Practice address
402 N Main St
Kenansville, NC 28349-8801
Phone
(910) 296-1781
Fax
(910) 296-1843
NPI assigned
Jan 10, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2020

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

Authorized official

Name
Mrs. Gail Stroud Terry
Title
Administrator
Phone
(910) 296-1781

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X Primary

Addresses

Primary practice location

402 N Main St
Kenansville, NC 28349-8801

Mailing address

PO Box 486
Kenansville, NC 28349-0486
Phone (910) 296-1781

Other identifiers 1

IdentifierTypeStateIssuer
7909129MedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040616000158 NC Part B Supplier - Clinic/Group Practice 1355325408 Receives reassigned benefits from 2 practitioners
Practice locations: Kenansville, NC

National Provider Directory

National Provider Directory

Interoperability endpoints

  • Direct secure messaging: johnpa@duplineye.eyefinity-direct.com
  • Direct secure messaging: ericyopp@duplineye.eyefinity-direct.com

Practitioners & affiliated clinicians

Practitioners 6

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": "1136851200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1581292800000",
    "number": "1508845587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 486",
            "city": "KENANSVILLE",
            "state": "NC",
            "postal_code": "283490486",
            "telephone_number": "910-296-1781",
            "fax_number": "910-296-1843"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "402 N MAIN ST",
            "city": "KENANSVILLE",
            "state": "NC",
            "postal_code": "283498801",
            "telephone_number": "910-296-1781",
            "fax_number": "910-296-1843"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DUPLIN EYE ASSOCIATES PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-10",
        "last_updated": "2020-02-10",
        "certification_date": "2020-02-10",
        "status": "A",
        "authorized_official_last_name": "TERRY",
        "authorized_official_first_name": "GAIL",
        "authorized_official_middle_name": "STROUD",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "910-296-1781",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7909129",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kenansville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2020; 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.