NPIMap

Organization Active NPI

Ocular Prosthetics Inc

Doing business as LaVon Drake Ocularist

  • Ocularist
  • Wilmington, NC
National Provider Identifier
1619941168
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OcularistTaxonomy code 156FX1700X
Legal business name
OCULAR PROSTHETICS INC
Doing business as
LaVon Drake Ocularist
Practice address
4557 Technology Dr
#5
Wilmington, NC 28405-2145
Phone
(800) 579-6363
Fax
(800) 579-6363
NPI assigned
Feb 13, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mrs. Lavon H DrakeNPI 1306044631
Title
President Owner
Phone
(252) 531-3153

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
Ocularist 156FX1700X Primary

Addresses

Primary practice location

4557 Technology Dr
#5
Wilmington, NC 28405-2145

Mailing address

6626 US Highway 264 E
Washington, NC 27889
Phone (252) 946-7618

Other identifiers 1

IdentifierTypeStateIssuer
DE2629MedicaidSC

Other names 1

  • LaVon Drake Ocularist Doing business as

National Provider Directory

National Provider Directory

Locations

4557 Technology Dr
Ste 5
Wilmington, NC 28405
Phone (252) 946-7618

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1139788800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1619941168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6626 US HIGHWAY 264 E",
            "city": "WASHINGTON",
            "state": "NC",
            "postal_code": "27889",
            "telephone_number": "252-946-7618",
            "fax_number": "252-946-7618"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4557 TECHNOLOGY DR",
            "address_2": "#5",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284052145",
            "telephone_number": "800-579-6363",
            "fax_number": "800-579-6363"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OCULAR PROSTHETICS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-13",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DRAKE",
        "authorized_official_first_name": "LAVON",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "PRESIDENT OWNER",
        "authorized_official_telephone_number": "252-531-3153",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "156FX1700X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Ocularist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "DE2629",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LaVon Drake Ocularist",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Wilmington, NC

Sources for this page

  • 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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.