Individual provider Active NPI

Haley A Perry, O.D.

  • Optometrist
  • Arden, NC
National Provider Identifier
1629302005
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2164 Issued in NC
Practice address
140 Airport Rd
Suite L
Arden, NC 28704
Phone
(828) 687-7500
Fax
(828) 687-7333
NPI assigned
Oct 1, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2164 NC Primary

Addresses

Primary practice location

140 Airport Rd
Suite L
Arden, NC 28704

Mailing address

140 Airport Rd
Suite L
Arden, NC 28704
Phone (828) 687-7500

Other identifiers 3

IdentifierTypeStateIssuer
NC2164OtherNCSTATE LIC
1597HOtherNCBLUE CROSS BLUE SHIELD
5918058MedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101112000118 NC Practitioner - Optometry 6204021975 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University Alabama Birmingham - School of Optometry, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ammons Perry Optometric PLLCGroup PAC ID 9537331715, 3 clinicians

Practice addresses (Care Compare)

140 Airport Rd
Suite B
Arden, NC 28704-8333
Phone (828) 687-7500

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2164NCMDCounselor

Practice roles

OrganizationSpecialtyStatusNew patients
Ammons Perry Optometric, PLLC Optometrist CurrentSince Jun 16, 2011 Accepting new patients
Elite Eye Care, O.D, P.L.L.C Optometrist CurrentSince Jul 24, 2022 Accepting new patients
Tri City Optometric, P.a. Optometrist PastSince Nov 1, 2004 Accepting new patients
PMV Optometry, P.a. Optometrist PastSince Oct 10, 2016 Accepting new patients
Randy a. Omlor, OD PA Optometrist Past Accepting new patients

Locations

140 Airport Rd
Ste B
Arden, NC 28704
Phone (828) 628-6700

140 Airport Rd
Ste L
Arden, NC 28704
Phone (828) 687-7500

1509 Charlotte Hwy
Fairview, NC 28730
Phone (828) 628-6700

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1254355200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1629302005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "140 AIRPORT RD",
            "address_2": "SUITE L",
            "city": "ARDEN",
            "state": "NC",
            "postal_code": "28704",
            "telephone_number": "828-687-7500",
            "fax_number": "828-687-7333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 AIRPORT RD",
            "address_2": "SUITE L",
            "city": "ARDEN",
            "state": "NC",
            "postal_code": "28704",
            "telephone_number": "828-687-7500",
            "fax_number": "828-687-7333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERRY",
        "first_name": "HALEY",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-10-01",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NC",
            "license": "2164",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LIC",
            "identifier": "NC2164",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "1597H",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5918058",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Arden, NC

Sources for this page

Verify at the official NPI Registry.