NPIMap

Organization Active NPI

Davis Eye Associates OD, PA

  • Corneal and Contact Management Optometrist
  • Winston Salem, NC
National Provider Identifier
1518189976
Registry record updated Apr 9, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Corneal and Contact Management OptometristTaxonomy code 152WC0802X
Legal business name
DAVIS EYE ASSOCIATES OD, PA
Practice address
3316 Silas Creek Pkwy
Davis Eye Associates OD PA
Winston Salem, NC 27103-3011
Phone
(336) 765-5350
Fax
(336) 765-0769
NPI assigned
May 3, 2007
Last updated
Apr 9, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2013

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

Authorized official

Name
Dr. Roger G Davis, ODNPI 1205859832
Title
President
Phone
(336) 765-5350

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Corneal and Contact Management Optometrist 152WC0802X NC Primary

Addresses

Primary practice location

3316 Silas Creek Pkwy
Davis Eye Associates OD PA
Winston Salem, NC 27103-3011

Mailing address

3316 Silas Creek Pkwy
Winston Salem, NC 27103-3011
Phone (336) 765-5350

Other identifiers 1

IdentifierTypeStateIssuer
7901453MedicaidNC

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1178150400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1365465600000",
    "number": "1518189976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3316 SILAS CREEK PKWY",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271033011",
            "telephone_number": "336-765-5350",
            "fax_number": "336-765-0769"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3316 SILAS CREEK PKWY",
            "address_2": "DAVIS EYE ASSOCIATES OD PA",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271033011",
            "telephone_number": "336-765-5350",
            "fax_number": "336-765-0769"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVIS EYE ASSOCIATES OD, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-03",
        "last_updated": "2013-04-09",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "ROGER",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "336-765-5350",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "NC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7901453",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Winston Salem, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2013; 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.