Organization Active NPI

W. Alex Appanaitis, O.D., P.a.

Doing business as Forsyth Family Eye Care

  • Optometrist
  • Winston Salem, NC
National Provider Identifier
1578749180
Registry record updated Jul 8, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1655 Issued in NC
Legal business name
W. ALEX APPANAITIS, O.D., P.A.
Doing business as
Forsyth Family Eye Care
Practice address
5305 Robinhood Village Dr
Winston Salem, NC 27106-9820
Phone
(336) 924-9121
Fax
(336) 924-6215
NPI assigned
Jan 14, 2008
Last updated
Jul 8, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2015

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

Authorized official

Name
Dr. Walter Alexander Appanaitis, O.D.NPI 1144240557
Title
Owner
Phone
(336) 924-9121

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1655 NC Primary

Addresses

Primary practice location

5305 Robinhood Village Dr
Winston Salem, NC 27106-9820

Mailing address

312 Sonata Dr
Lewisville, NC 27023-8301
Phone (336) 924-9121

Other identifiers 2

IdentifierTypeStateIssuer
5950461MedicaidNC
890914WMedicaidNC

Other names 1

  • Forsyth Family Eye Care Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080130000782 NC Part B Supplier - Clinic/Group Practice 9537241401 Receives reassigned benefits from 3 practitioners
Practice locations: Winston Salem, NC

National Provider Directory

National Provider Directory

Locations

3800 Reynolda Rd
Ste 300
Winston Salem, NC 27106
Phone (336) 924-9121

5305 Robinhood Village Dr
Winston Salem, NC 27106
Phone (336) 924-9121

Practitioners & affiliated clinicians

Practitioners 3

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": "1200268800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1436313600000",
    "number": "1578749180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "312 SONATA DR",
            "city": "LEWISVILLE",
            "state": "NC",
            "postal_code": "270238301",
            "telephone_number": "336-924-9121",
            "fax_number": "336-924-6215"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5305 ROBINHOOD VILLAGE DR",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271069820",
            "telephone_number": "336-924-9121",
            "fax_number": "336-924-6215"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "W. ALEX APPANAITIS, O.D., P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-14",
        "last_updated": "2015-07-08",
        "status": "A",
        "authorized_official_last_name": "APPANAITIS",
        "authorized_official_first_name": "WALTER",
        "authorized_official_middle_name": "ALEXANDER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "336-924-9121",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NC",
            "license": "1655",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5950461",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "890914W",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Forsyth Family Eye Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Jul 8, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.