Individual provider Active NPI

Angela B Gray, OD

  • Optometrist
  • Beaufort, NC
National Provider Identifier
1609813666
Registry record updated Dec 3, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1577 Issued in NC
Practice address
300 Campen Rd
Suite a
Beaufort, NC 28516-1597
Phone
(252) 838-8822
NPI assigned
May 31, 2006
Last updated
Dec 3, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1577 NC Primary

Addresses

Primary practice location

300 Campen Rd
Suite a
Beaufort, NC 28516-1597

Mailing address

300 Campen Rd
Beaufort, NC 28516-1597
Phone (252) 838-8822

Other identifiers 2

IdentifierTypeStateIssuer
890917GMedicaidNC
0917GOtherNCBCBSNC INDIVIDUAL NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050531001040 NC Practitioner - Optometry 6305888389 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University Alabama Birmingham - School of Optometry, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

300 Campen Rd
Suite a
Beaufort, NC 28516-1500
Phone (252) 838-8822

4252 Arendell St
Suite G
Morehead City, NC 28557-0015
Phone (252) 838-8822

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery61

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1577NCMDHearing Instrument Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Insight Optometric Services Optometrist CurrentSince Jun 10, 2016 Accepting new patients
Insight Optometric Services P a Optometrist CurrentSince Jun 10, 2016 Accepting new patients

Locations

300 Campen Rd
Ste A
Beaufort, NC 28516
Phone (252) 838-8822

4252 Arendell St
Ste G
Morehead City, NC 28557
Phone (252) 222-3090

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1149033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1480723200000",
    "number": "1609813666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 CAMPEN RD",
            "city": "BEAUFORT",
            "state": "NC",
            "postal_code": "285161597",
            "telephone_number": "252-838-8822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 CAMPEN RD",
            "address_2": "SUITE A",
            "city": "BEAUFORT",
            "state": "NC",
            "postal_code": "285161597",
            "telephone_number": "252-838-8822"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAY",
        "first_name": "ANGELA",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-31",
        "last_updated": "2016-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NC",
            "license": "1577",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "890917G",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSNC INDIVIDUAL NUMBER",
            "identifier": "0917G",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Beaufort, NC

Sources for this page

Verify at the official NPI Registry.