Active NPI
P. Duncan Roy Jr., O.D.
- Optometrist
- Childersburg, AL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- S-471-TA-079
- Practice address
- 34011 US Highway 280
Childersburg, AL 35044-2128 - Phone
- (256) 378-5507
- Fax
- (256) 378-5325
- NPI assigned
- Nov 9, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | S-471-TA-079 | AL | Primary |
Addresses
Primary practice location
34011 US Highway 280
Childersburg, AL 35044-2128
Mailing address
PO Box J
Childersburg, AL 35044-0510
Phone (256) 378-5507
Other identifiers 6
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 631019335 | Other | AL | UNITED HEALTHCARE |
| 631019335 | Other | KY | HUMANA DENTAL |
| 510-59662 | Other | AL | BLUE CROSS |
| 102I413417 | Other | AL | MEDICARE ID |
| 000059662 | Medicaid | AL | |
| 000059662 | Other | AL | MEDICARE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Optometry
- Education
- University of Alabama School of Medicine, 1981
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
2100 Devereux Cir
Suite 100
Vestavia, AL 35243-2558
Phone (205) 879-2221
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| S-471-TA-079 | AL | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Invision Ophthalmology P.C. | Current | Accepting new patients | |
| Invision Ophthalmology P.C. | Current | Accepting new patients | |
| J Waid Blackstone, M.D., LLC | Past | Accepting new patients |
Locations
16233 Highway 280
Chelsea, AL 35043
Phone (205) 678-2020
16233 Highway 280
Ste 100
Chelsea, AL 35043
Phone (205) 678-2020
2100 Devereux Cir
Ste 100
Vestavia, AL 35243
Phone (205) 871-7767
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Ophthalmology Physician
- Vestavia, AL
- NPI 1063730596
-
- Ambulatory Surgical Clinic/Center
- Vestavia, AL
- NPI 1982055638
-
- Clinic/Center
- Sylacauga, AL
- NPI 1285843888
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163030400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1401926400000",
"number": "1508936014",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX J",
"city": "CHILDERSBURG",
"state": "AL",
"postal_code": "350440510",
"telephone_number": "256-378-5507",
"fax_number": "256-378-5325"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "34011 US HIGHWAY 280",
"city": "CHILDERSBURG",
"state": "AL",
"postal_code": "350442128",
"telephone_number": "256-378-5507",
"fax_number": "256-378-5325"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROY",
"first_name": "P. DUNCAN",
"name_suffix": "Jr.",
"credential": "O.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-11-09",
"last_updated": "2014-06-05",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "AL",
"license": "S-471-TA-079",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HEALTHCARE",
"identifier": "631019335",
"state": "AL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HUMANA DENTAL",
"identifier": "631019335",
"state": "KY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS",
"identifier": "510-59662",
"state": "AL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE ID",
"identifier": "102I413417",
"state": "AL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "000059662",
"state": "AL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE",
"identifier": "000059662",
"state": "AL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Childersburg, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.