Organization Active NPI

Washington Eye Clinic Optical

  • Eyewear Supplier
  • Washington, NC
National Provider Identifier
1619996196
Registry record updated Dec 23, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Eyewear SupplierTaxonomy code 332H00000X
Legal business name
WASHINGTON EYE CLINIC OPTICAL
Practice address
639 W 15TH St
Washington, NC 27889-3526
Phone
(252) 946-2171
Fax
(252) 946-5986
NPI assigned
Jul 18, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 23, 2009

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

Authorized official

Name
Mrs. Linda Jewell
Title
Office Manager
Phone
(252) 946-2171

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Eyewear Supplier 332H00000X Primary

Addresses

Primary practice location

639 W 15TH St
Washington, NC 27889-3526

Mailing address

639 W 15TH St
Washington, NC 27889-3526
Phone (252) 946-2171

Other identifiers 2

IdentifierTypeStateIssuer
8802048MedicaidNC
02876OtherNCBLUE CROSS BLUE SHIELD NC

National Provider Directory

National Provider Directory

Locations

639 W 15th St
Washington, NC 27889
Phone (252) 946-2171

NPI Registry JSON

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

{
    "created_epoch": "1153180800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1261526400000",
    "number": "1619996196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "639 W 15TH ST",
            "city": "WASHINGTON",
            "state": "NC",
            "postal_code": "278893526",
            "telephone_number": "252-946-2171",
            "fax_number": "252-946-5986"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "639 W 15TH ST",
            "city": "WASHINGTON",
            "state": "NC",
            "postal_code": "278893526",
            "telephone_number": "252-946-2171",
            "fax_number": "252-946-5986"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WASHINGTON EYE CLINIC OPTICAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-18",
        "last_updated": "2009-12-23",
        "status": "A",
        "authorized_official_last_name": "JEWELL",
        "authorized_official_first_name": "LINDA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "252-946-2171",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8802048",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD NC",
            "identifier": "02876",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2009; 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.