Patty Vision Center OD PA

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

PATTY VISION CENTER OD PA

Doing business as

Mebane Vision Center

Practice address

1107 S Fifth St Ste 300
Mebane, NC 27302-9896

Phone

(919) 241-8554

Fax

(336) 597-3356

NPI assigned

Nov 1, 2017

Last updated

Nov 1, 2017By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jenny M Powell

Title

Assistant

Phone

(336) 599-0246

Specialties & licenses 1

Addresses

Other names 1

• Mebane Vision Center Doing business as

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Other NPIs on the same Medicare enrollment 3

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Patty Vision Center OD PA

  • Optometrist
  • Yanceyville, NC
  • NPI 1497798177

  O20040724000414

  Same enrollment
• Patty Vision Center OD PA

  • Optometrist
  • Burlington, NC
  • NPI 1548217755

  O20040724000414

  Same enrollment
• Patty Vision Center OD PA

  • Optometrist
  • Roxboro, NC
  • NPI 1740339449

  O20040724000414

  Same enrollment

Locations

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

{
    "created_epoch": "1509494400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1509494400000",
    "number": "1598277402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1107 S FIFTH ST STE 300",
            "city": "MEBANE",
            "state": "NC",
            "postal_code": "273029896",
            "telephone_number": "919-241-8554",
            "fax_number": "336-597-3356"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1107 S FIFTH ST STE 300",
            "city": "MEBANE",
            "state": "NC",
            "postal_code": "273029896",
            "telephone_number": "919-241-8554",
            "fax_number": "336-597-3356"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PATTY VISION CENTER OD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-11-01",
        "last_updated": "2017-11-01",
        "status": "A",
        "authorized_official_last_name": "POWELL",
        "authorized_official_first_name": "JENNY",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "ASSISTANT",
        "authorized_official_telephone_number": "336-599-0246"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mebane Vision Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Elizabeth Marie Paisley, LCSW
• Pam Fogleman
• Wenjing Pang
• Aaron Park, D.D.S., M.D.
• Rupali Gaman Patel, PHARMD
• Miranda Peoples, LCMHCS
• Rachel Elizabeth Pertschi, PHARMD
• Alexander Moore Pettus, MS, LCMHCA, NCC
• Hieu D Pham, PHARM.D
• Meredith Pope, LPC

• Optometrist in Mebane, NC
• Providers in Mebane, NC by specialty
• Optometrist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2017; 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.