Individual provider Active NPI

John Reynolds Todd, OPTICIAN

  • Optician
  • Rocky Mount, NC
National Provider Identifier
1619813318
Registry record updated Apr 25, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
OpticianTaxonomy code 156FX1800X
License
1052 Issued in NC
Practice address
1511 Benvenue Rd
Rocky Mount, NC 27804-6383
Phone
(252) 442-5666
Fax
(252) 442-8650
NPI assigned
Apr 25, 2026
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optician 156FX1800X 1052 NC Primary

Addresses

Primary practice location

1511 Benvenue Rd
Rocky Mount, NC 27804-6383

Mailing address

1511 Benvenue Rd
Rocky Mount, NC 27804-6383
Phone (252) 442-5666

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
1052NCMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1777075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777075200000",
    "number": "1619813318",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1511 BENVENUE RD",
            "city": "ROCKY MOUNT",
            "state": "NC",
            "postal_code": "278046383",
            "telephone_number": "252-442-5666",
            "fax_number": "252-442-8650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1511 BENVENUE RD",
            "city": "ROCKY MOUNT",
            "state": "NC",
            "postal_code": "278046383",
            "telephone_number": "252-442-5666",
            "fax_number": "252-442-8650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TODD",
        "first_name": "JOHN",
        "middle_name": "REYNOLDS",
        "credential": "OPTICIAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-04-25",
        "last_updated": "2026-04-25",
        "certification_date": "2026-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Optician",
            "state": "NC",
            "license": "1052",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rocky Mount, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2026; 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.