Active NPI
Wavely Lee Sledge, D.O.
- Optician
- Fayetteville, NC
National Provider Identifier
1518155712
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optician
- License
- 826
- Practice address
- 160 Bienville Dr
Fayetteville, NC 28311-9335 - Phone
- (910) 488-0598
- Fax
- (910) 488-0598
- NPI assigned
- Oct 12, 2007
- 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 |
|---|---|---|---|---|
| Optician | 156FX1800X | 826 | NC | Primary |
Addresses
Primary practice location
160 Bienville Dr
Fayetteville, NC 28311-9335
Mailing address
160 Bienville Dr
Fayetteville, NC 28311-9335
Phone (910) 488-0598
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8801882 | Medicaid | NC |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 826 | NC | MD | Audiologist-Hearing Aid Fitter |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1192147200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1192147200000",
"number": "1518155712",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "160 BIENVILLE DR",
"city": "FAYETTEVILLE",
"state": "NC",
"postal_code": "283119335",
"telephone_number": "910-488-0598",
"fax_number": "910-488-0598"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "160 BIENVILLE DR",
"city": "FAYETTEVILLE",
"state": "NC",
"postal_code": "283119335",
"telephone_number": "910-488-0598",
"fax_number": "910-488-0598"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SLEDGE",
"first_name": "WAVELY",
"middle_name": "LEE",
"credential": "D.O.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-10-12",
"last_updated": "2007-10-12",
"status": "A"
},
"taxonomies": [
{
"code": "156FX1800X",
"taxonomy_group": "",
"desc": "Technician/Technologist, Optician",
"state": "NC",
"license": "826",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8801882",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Fayetteville, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.