Individual provider Active NPI

Rex H Freeman III, O.D.

  • Optometrist
  • Kernersville, NC
National Provider Identifier
1699793067
Registry record updated Aug 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1118 Issued in NC
Practice address
1575 Hwy. 66 So.
Kernersville, NC 27284
Phone
(336) 993-6880
Fax
(336) 993-6950
NPI assigned
Jul 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1118 NC Primary

Addresses

Primary practice location

1575 Hwy. 66 So.
Kernersville, NC 27284

Mailing address

1575 Hwy 66 South
Kernersville, NC 27284
Phone (336) 993-6880

Other identifiers 1

IdentifierTypeStateIssuer
8909295MedicaidNC

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
I20120302000571 NC Practitioner - Optometry 1951415140 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Eyecarecenter OD PAGroup PAC ID 7315834462, shared by 4 NPIs, 71 clinicians

Practice addresses (Care Compare)

1575 NC Hwy 66 S
Kernersville, NC 27284-3516
Phone (336) 993-8514

2630 Peters Creek Pkwy
Winston Salem, NC 27127-5655
Phone (336) 785-3486

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1118NCMDHearing Instrument Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Eyecarecenter, O.D., P.a. Optometrist CurrentSince May 1, 2017 Accepting new patients
Eyecarecenter OD PA Optometrist Current Accepting new patients
Eyecarecenter OD PA Optometrist CurrentSince May 1, 2017 Accepting new patients
Eyecarecenter OD PA Optometrist CurrentSince May 1, 2017 Accepting new patients
C.V. Sikes,Jr. & R.B. Gotschalk PTR Optometrist Past Accepting new patients

Locations

1575 NC Highway 66 S
Kernersville, NC 27284
Phone (336) 933-8514

819 Tiffany Blvd
Rocky Mount, NC 27804
Phone (252) 972-2020

5121 Reidsville Rd
Walkertown, NC 27051
Phone (336) 595-4588

2630 Peters Creek Pkwy
Winston Salem, NC 27127
Phone (336) 785-3486

Interoperability endpoints

  • Direct secure messaging: rfreeman@direct.eyecare-partners.com

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": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629244800000",
    "number": "1699793067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1575 HWY 66 SOUTH",
            "city": "KERNERSVILLE",
            "state": "NC",
            "postal_code": "27284",
            "telephone_number": "336-993-6880",
            "fax_number": "336-993-6950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1575 HWY. 66 SO.",
            "city": "KERNERSVILLE",
            "state": "NC",
            "postal_code": "27284",
            "telephone_number": "336-993-6880",
            "fax_number": "336-993-6950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREEMAN",
        "first_name": "REX",
        "middle_name": "H",
        "name_suffix": "III",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-17",
        "last_updated": "2021-08-18",
        "certification_date": "2021-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NC",
            "license": "1118",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8909295",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kernersville, NC

Sources for this page

Verify at the official NPI Registry.