Active NPI
Carolina Family Optometry, PLLC
- Optometrist
- Statesville, NC
National Provider Identifier
1639137888
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 1887
- Legal business name
- CAROLINA FAMILY OPTOMETRY, PLLC
- Practice address
- 1116 Crossroads Dr
Statesville, NC 28625-8277 - Phone
- (704) 872-0616
- Fax
- (704) 872-6494
- NPI assigned
- May 3, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Jay Drennen Crim, OD
- Title
- Partner/Owner
- Phone
- (704) 872-0616
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 1887 | NC | Primary |
Addresses
Primary practice location
1116 Crossroads Dr
Statesville, NC 28625-8277
Mailing address
1116 Crossroads Dr
Statesville, NC 28625-8277
Phone (704) 872-0616
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 015EX | Other | NC | GROUP NUMBER (BCBS) |
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 2
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Emergency Medical Services (Emergency Medicine) Physician
- Augusta, GA
- NPI 1588622732
Optometrist
-
- Optometrist
- Franklin, TN
- NPI 1609834845
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1146614400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598054400000",
"number": "1639137888",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1116 CROSSROADS DR",
"city": "STATESVILLE",
"state": "NC",
"postal_code": "286258277",
"telephone_number": "704-872-0616",
"fax_number": "704-872-6494"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1116 CROSSROADS DR",
"city": "STATESVILLE",
"state": "NC",
"postal_code": "286258277",
"telephone_number": "704-872-0616",
"fax_number": "704-872-6494"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "CAROLINA FAMILY OPTOMETRY, PLLC",
"organizational_subpart": "NO",
"enumeration_date": "2006-05-03",
"last_updated": "2020-08-22",
"status": "A",
"authorized_official_last_name": "CRIM",
"authorized_official_first_name": "JAY",
"authorized_official_middle_name": "DRENNEN",
"authorized_official_title_or_position": "PARTNER/OWNER",
"authorized_official_telephone_number": "704-872-0616",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "OD"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Optometrist",
"state": "NC",
"license": "1887",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GROUP NUMBER (BCBS)",
"identifier": "015EX",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Statesville, NC
- Sarah Carney, SLP-CCC
- Caro Medical LLC
- Carolina Anesthesia Associates PA
- Carolina Comprehensive Health Network, PA
- Carolina Family Medicine & Urgent Care PA
- Carolina Health Professionals Inc
- Carolina Health Professionals, Inc.
- Carolina Health Professionals, Inc.
- Carolina Health Professionals, Inc.
- Carolina Health Proffesionals, Inc.
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.