Bethesda Eye Center, Optometry, PA

Primary specialty

OptometristTaxonomy code 152W00000X

License

1456 Issued in NC

Legal business name

BETHESDA EYE CENTER, OPTOMETRY, PA

Practice address

3111 Maplewood Ave
Suite 103
Winston Salem, NC 27103-3906

Phone

(336) 765-8130

Fax

(336) 765-6403

NPI assigned

Feb 8, 2007

Organization subpart

No

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

Authorized official

Name

Dr. J Grady Elliott, O.D.

Title

President

Phone

(336) 765-8130

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

Practitioners 1

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

• Thuyvan Vo, OD

  • Optometrist
  • Winston Salem, NC
  • NPI 1982032959
  NPD

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

{
    "created_epoch": "1170892800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1305504000000",
    "number": "1518007491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3111 MAPLEWOOD AVE",
            "address_2": "SUITE 103",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271033906",
            "telephone_number": "336-765-8130",
            "fax_number": "336-765-6403"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3111 MAPLEWOOD AVE",
            "address_2": "SUITE 103",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271033906",
            "telephone_number": "336-765-8130",
            "fax_number": "336-765-6403"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BETHESDA EYE CENTER, OPTOMETRY, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-08",
        "last_updated": "2011-05-16",
        "status": "A",
        "authorized_official_last_name": "ELLIOTT",
        "authorized_official_first_name": "J GRADY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "336-765-8130",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "NC",
            "license": "1456",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE - PTAN",
            "identifier": "2468143",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8801962",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bethany Medical Center
• Bethany Medical Center, PA
• James Frank Bethea, MD
• Nancy Marie Bethea, LPC
• Bethesda Clinic PA
• Jonathan Blair Bethiel, MD
• Better Opportunities LLC
• Bettertherapy LLC
• Kristen Marisa Bettis, CRNA
• Michael A Bettmann, MD

• Optometrist in Winston Salem, NC
• Providers in Winston Salem, NC by specialty
• Optometrist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.