Myeyedr Optometry of North Carolina, PLLC

Organization Active NPI Optometrist · Knightdale, NC

NPI 1639572811 · NPPES record last updated May 29, 2022

Key facts

NPI
1639572811
Entity type
Organization (NPI type 2)
Primary specialty
Optometrist 152W00000X
Legal business name
MYEYEDR OPTOMETRY OF NORTH CAROLINA, PLLC
Practice address
1001 Widewaters Pkwy
Knightdale, NC 27545-6102
Phone
(919) 861-2020
Fax
(919) 277-0854
NPI assigned
Oct 2, 2014
Organization subpart
No

Authorized official

Name
Sue Healey
Title
Secretary
Phone
(703) 847-8899

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Laboratory certificates & supplier records

Name & address match These CMS records do not include an NPI. They are shown here because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
34D2300807Myeyedr Optometry of North Carolina, PLLC
1001 Widewaters Pkwy, Knightdale, NC 27545
Certificate of waiverMar 14, 2028

Medicare participation

Medicare fee-for-service enrollment
Enrolled in NC

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20130904000726 NC Part B Supplier - Clinic/Group Practice 6608019096 Receives reassigned benefits from 258 practitioners
This NPI is an additional NPI on the enrollment

National Provider Directory

Locations

499 Greenville Blvd SE
Greenville, NC 27858
Phone (252) 756-9404

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist
Group: 193400000X SINGLE SPECIALTY GROUP
152W00000X Yes

Addresses

Primary practice location

1001 Widewaters Pkwy
Knightdale, NC 27545-6102

Mailing address

8614 Westwood Center Dr FL 9
Vienna, VA 22182-2442
Phone (703) 847-8899

Other names

  • Myeyedr Doing business as

Other providers in Knightdale, NC

All providers in Knightdale, NC · Optometrist in North Carolina

Sources for this page

Verify at the official NPI Registry.