Triad Eye Associates OD PA

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

TRIAD EYE ASSOCIATES OD PA

Practice address

10564 N Main St
Suite E
Archdale, NC 27263-2808

Phone

(336) 434-4033

Fax

(336) 434-6680

NPI assigned

May 4, 2006

Last updated

Apr 15, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Lisa D Moody

Title

Director of Insurance

Phone

(336) 687-7730

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Locations

Interoperability endpoints

• Direct secure messaging: gilliam@triadeyeassociates.eyeclinicdirect.net

Practitioners 12

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jacob Blackman, OD

  • Optometrist
  • King, NC
  • NPI 1558111575
  Medicare reassignment Care Compare group NPD
• Lauren Cadwell

  • Optometrist
  • High Point, NC
  • NPI 1316781552
  Medicare reassignment Care Compare group NPD
• Mitchell N Evans, OD

  • Optometrist
  • Archdale, NC
  • NPI 1053147769
  Medicare reassignment Care Compare group NPD
• Cathy A Fulp, O.D.

  • Optometrist
  • Archdale, NC
  • NPI 1902803323
  Medicare reassignment Care Compare group NPD
• William Neal Hutto, OD

  • Optometrist
  • High Point, NC
  • NPI 1821191669
  Medicare reassignment Care Compare group NPD
• Ryan E Snipes, OD

  • Optometrist
  • Randleman, NC
  • NPI 1992867402
  Medicare reassignment Care Compare group NPD
• Charles Rick Gilliam, O.D.

  • Optometrist
  • High Point, NC
  • NPI 1720083199
  Medicare reassignment NPD
• Stacey S Hutto, O.D.

  • Optometrist
  • Greensboro, NC
  • NPI 1447234711
  Medicare reassignment NPD
• Kimberly G Orr, OD

  • Optometrist
  • Greensboro, NC
  • NPI 1043611734
  Medicare reassignment NPD
• James M Kernodle Jr., OD PA

  • Optometrist
  • Asheboro, NC
  • NPI 1154326528
  NPD (past)
• Timothy Gerrit Koop, O.D.

  • Optometrist
  • Greensboro, NC
  • NPI 1932250834
  NPD (past)
• Jeffrey Strand, OD

  • Optometrist
  • Zebulon, NC
  • NPI 1063405447
  NPD (past)

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

{
    "created_epoch": "1146700800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1744675200000",
    "number": "1649228669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4370",
            "city": "ARCHDALE",
            "state": "NC",
            "postal_code": "272634370",
            "telephone_number": "336-434-4033",
            "fax_number": "336-434-6680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10564 N MAIN ST",
            "address_2": "SUITE E",
            "city": "ARCHDALE",
            "state": "NC",
            "postal_code": "272632808",
            "telephone_number": "336-434-4033",
            "fax_number": "336-434-6680"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRIAD EYE ASSOCIATES OD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-04",
        "last_updated": "2025-04-15",
        "certification_date": "2025-04-15",
        "status": "A",
        "authorized_official_last_name": "MOODY",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "DIRECTOR OF INSURANCE",
        "authorized_official_telephone_number": "336-687-7730"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS/NC",
            "identifier": "0274P",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Optometrist in Archdale, NC
• Providers in Archdale, NC by specialty
• Optometrist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.