Carlyle Dukes Haywood Jr

Primary specialty

OptometristTaxonomy code 152W00000X

License

1566 Issued in NC

Legal business name

CARLYLE DUKES HAYWOOD JR

Practice address

211 W Broad Ave
Rockingham, NC 28379-3529

Phone

(910) 997-7500

NPI assigned

Feb 5, 2007

Last updated

Aug 22, 2020By 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

Dr. Carlyle HaywoodNPI 1144204579

Title

Owner

Phone

(910) 997-7500

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Carlyle Dukes Haywood, Jr.

  • Optometrist
  • Troy, NC
  • NPI 1043357643

  2264480029

  Same PAC ID

Other NPIs on the same Medicare enrollment 1

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

• Carlyle Dukes Haywood, Jr.

  • Optometrist
  • Troy, NC
  • NPI 1043357643

  O20080528000108

  Same enrollment

Tax ID family

Montgomery Eye Care2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Carlyle Dukes Haywood, Jr.

  • Optometrist
  • Troy, NC
  • NPI 1043357643
  NPD tax ID

Locations

Practitioners 8

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.

• Carlyle Dukes Haywood Jr.

  • Optometrist
  • Troy, NC
  • NPI 1144204579
  Medicare reassignment NPD Authorized official
• Julianne Marie Grissom, OD

  • Optometrist
  • Winston Salem, NC
  • NPI 1942827043
  Medicare reassignment NPD
• Stephanie Corbin, OD

  • Optometrist
  • Chicago, IL
  • NPI 1124545603

  NC

  Medicare reassignment NPD
• Samuel E Cox, O.D.

  • Optometrist
  • Johnson City, TN
  • NPI 1972608974

  NC

  Medicare reassignment NPD
• Vanessa M Mills, O.D.

  • Optometrist
  • Charlotte, NC
  • NPI 1912932112
  Medicare reassignment NPD (past)
• Roger Wayne Luck, OPTICIAN

  • Optician
  • Rockingham, NC
  • NPI 1386723237
  NPD (past)
• Yupheng Ly, O.D.

  • Optometrist
  • Hickory, NC
  • NPI 1417265976
  NPD (past)
• Kevin James Ritter, O.D.

  • Optometrist
  • Hillsborough, NC
  • NPI 1801870118
  NPD (past)

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

{
    "created_epoch": "1170633600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1609914100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 W BROAD AVE",
            "city": "ROCKINGHAM",
            "state": "NC",
            "postal_code": "283793529"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 W BROAD AVE",
            "city": "ROCKINGHAM",
            "state": "NC",
            "postal_code": "283793529",
            "telephone_number": "910-997-7500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARLYLE DUKES HAYWOOD JR",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-05",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HAYWOOD",
        "authorized_official_first_name": "CARLYLE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "910-997-7500",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NC",
            "license": "1566",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF NC",
            "identifier": "013H5",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "890908G",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDCOST",
            "identifier": "56162",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amy Scholl Butler, FNP-BC
• Cassandra McDonald Byers, LCAS, LCMHCS, CCS
• C T Short LLC (H & S Premier Services)
• Javrille Capel, LMBT, MMP
• Capital C Operations
• Carolina Behavioral Care
• Carolina Eye Associates Inc (Carolina Eye Associates PA)
• Carolina Family Comprehensive Services, Inc.
• Carolina Spine Center PA
• Gerard A. Catapano, D.O.

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.