Individual provider Active NPI

Rachelle Leigh Davis, O.D.

  • Optometrist
  • Greensboro, NC
National Provider Identifier
1659533164
Registry record updated Oct 24, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2130 Issued in NC
Practice address
1507 Westover Ter
Ste C
Greensboro, NC 27408-7130
Phone
(336) 274-7771
Fax
(336) 274-2024
NPI assigned
Jun 26, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 0618001745 VA
Optometrist 152W00000X 2130 NC Primary

Addresses

Primary practice location

1507 Westover Ter
Ste C
Greensboro, NC 27408-7130

Mailing address

1507 Westover Ter
Ste C
Greensboro, NC 27408-7130
Phone (336) 274-7771

Other identifiers 2

IdentifierTypeStateIssuer
093Y5OtherNCBCBS PROV #
5911975MedicaidNC

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
I20090723000816 NC Practitioner - Optometry 0446302327 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pennsylvania College of Optometry, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

703 S Van Buren Rd
Eden, NC 27288-5321
Phone (336) 627-1125

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery41

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0618001745VAMDOptometrist
2130NCMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Dr Rachelle Davis Optometrist PLLC Optometrist CurrentSince Oct 1, 2018 Accepting new patients
Myeyedr Optometry of North Carolina PLLC Optometrist Past Accepting new patients
Oasis Eye Care Optometry P.a. Optometrist Past Accepting new patients
Oasis Eye Care Optometry P.a. Optometrist Past Accepting new patients

Locations

703 S Van Buren Rd
#2
Eden, NC 27288
Phone (336) 627-1125

703 S Van Buren Rd
Bldg 2
Eden, NC 27288
Phone (336) 627-1125

703 S Van Buren Rd
Eden, NC 27288
Phone (336) 627-1125

Interoperability endpoints

  • Direct secure messaging: rachelle.davis@uprisedirect.com

Organizations & group practices 4

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": "1214438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571875200000",
    "number": "1659533164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1507 WESTOVER TER",
            "address_2": "STE C",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274087130",
            "telephone_number": "336-274-7771",
            "fax_number": "336-274-2024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1507 WESTOVER TER",
            "address_2": "STE C",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274087130",
            "telephone_number": "336-274-7771",
            "fax_number": "336-274-2024"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "RACHELLE",
        "middle_name": "LEIGH",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-26",
        "last_updated": "2019-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "VA",
            "license": "0618001745",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NC",
            "license": "2130",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROV #",
            "identifier": "093Y5",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5911975",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greensboro, NC

Sources for this page

Verify at the official NPI Registry.