NPIMap

Organization Active NPI

Park Ophthalmology

  • Ophthalmology Physician
  • Durham, NC
National Provider Identifier
1619150141
Registry record updated Dec 6, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
27794 Issued in NC
Legal business name
PARK OPHTHALMOLOGY
Practice address
5306 NC Highway 55
Suite 102
Durham, NC 27713-7812
Phone
(919) 544-5375
Fax
(919) 544-5829
NPI assigned
Dec 6, 2007
Last updated
Dec 6, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2007

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

Authorized official

Name
Beth R Friedland, M.D.NPI 1295728608
Title
Medical Director
Phone
(919) 544-5375

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
Ophthalmology Physician 207W00000X 27794 NC Primary

Addresses

Primary practice location

5306 NC Highway 55
Suite 102
Durham, NC 27713-7812

Mailing address

5306 NC Highway 55
Suite 102
Durham, NC 27713-7812
Phone (919) 544-5375

Other identifiers 1

IdentifierTypeStateIssuer
8933924MedicaidNC

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1,561

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.

View all 1,561

NPI Registry JSON

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

{
    "created_epoch": "1196899200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196899200000",
    "number": "1619150141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5306 NC HIGHWAY 55",
            "address_2": "SUITE 102",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277137812",
            "telephone_number": "919-544-5375",
            "fax_number": "919-544-5829"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5306 NC HIGHWAY 55",
            "address_2": "SUITE 102",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277137812",
            "telephone_number": "919-544-5375",
            "fax_number": "919-544-5829"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARK OPHTHALMOLOGY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-06",
        "last_updated": "2007-12-06",
        "status": "A",
        "authorized_official_last_name": "FRIEDLAND",
        "authorized_official_first_name": "BETH",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "919-544-5375",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NC",
            "license": "27794",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8933924",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Durham, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2007; 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.