Individual provider Active NPI

P. Duncan Roy Jr., O.D.

  • Optometrist
  • Childersburg, AL
National Provider Identifier
1508936014
Registry record updated Jun 5, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
S-471-TA-079 Issued in AL
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

Updated by the provider on Jun 5, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
631019335OtherALUNITED HEALTHCARE
631019335OtherKYHUMANA DENTAL
510-59662OtherALBLUE CROSS
102I413417OtherALMEDICARE ID
000059662MedicaidAL
000059662OtherALMEDICARE

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111026000324 AL Practitioner - Optometry 1951573591 Reassigns benefits to 1 organization

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
Invision Ophthalmology PCGroup PAC ID 9537352299, 6 clinicians

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

LicenseStateTypeSpecialty
S-471-TA-079ALMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Invision Ophthalmology P.C. CurrentSince Apr 12, 2025 Accepting new patients
Invision Ophthalmology P.C. CurrentSince Apr 12, 2025 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.

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

Verify at the official NPI Registry.