Organization Active NPI

Lawndale Optometry Associates PA

  • Optometrist
  • Greensboro, NC
National Provider Identifier
1629298211
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
LAWNDALE OPTOMETRY ASSOCIATES PA
Practice address
2154-A Lawndale Drive
Greensboro, NC 27408-7102
Phone
(336) 275-1254
NPI assigned
Apr 26, 2007
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
Mark Joseph Rebeck, OD
Title
President
Phone
(336) 275-1254

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193200000X MULTI-SPECIALTY GROUP 152W00000X Primary

Addresses

Primary practice location

2154-A Lawndale Drive
Greensboro, NC 27408-7102

Mailing address

2154-A Lawndale Drive
Greensboro, NC 27408-7102
Phone (336) 275-1254

National Provider Directory

National Provider Directory

Locations

2154 Lawndale Dr
#A
Greensboro, NC 27408
Phone (336) 275-1254

NPI Registry JSON

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

{
    "created_epoch": "1177545600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1629298211",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2154-A LAWNDALE DRIVE",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274087102",
            "telephone_number": "336-275-1254"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2154-A LAWNDALE DRIVE",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274087102",
            "telephone_number": "336-275-1254"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAWNDALE OPTOMETRY ASSOCIATES PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-26",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "REBECK",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "JOSEPH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "336-275-1254",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greensboro, 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.