Progressive Vision Optometric Group P.a.

Primary specialty

OptometristTaxonomy code 152W00000X

License

1689 Issued in NC

Legal business name

PROGRESSIVE VISION OPTOMETRIC GROUP P.A.

Practice address

3929 Tinsley Dr
Suite 101
High Point, NC 27265-1530

Phone

(336) 841-2028

Fax

(336) 841-2029

NPI assigned

Mar 3, 2008

Last updated

Jan 23, 2012By 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

Dr. Staci A Palmer, O.D.

Title

Optometrist/Vice-President

Phone

(336) 841-2028

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Locations

Practitioners 2

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.

• Joseph Nelson Perez Jr., O.D.

  • Optometrist
  • High Point, NC
  • NPI 1699771642
  Medicare reassignment NPD
• Staci Palmer Perez, OD.

  • Optometrist
  • High Point, NC
  • NPI 1528069754
  Medicare reassignment NPD

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

{
    "created_epoch": "1204502400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1327276800000",
    "number": "1700056066",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3929 TINSLEY DR",
            "address_2": "SUITE 101",
            "city": "HIGH POINT",
            "state": "NC",
            "postal_code": "272651530",
            "telephone_number": "336-841-2028",
            "fax_number": "336-841-2029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3929 TINSLEY DR",
            "address_2": "SUITE 101",
            "city": "HIGH POINT",
            "state": "NC",
            "postal_code": "272651530",
            "telephone_number": "336-841-2028",
            "fax_number": "336-841-2029"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROGRESSIVE VISION OPTOMETRIC GROUP P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-03",
        "last_updated": "2012-01-23",
        "status": "A",
        "authorized_official_last_name": "PALMER",
        "authorized_official_first_name": "STACI",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OPTOMETRIST/VICE-PRESIDENT",
        "authorized_official_telephone_number": "336-841-2028",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NC",
            "license": "1689",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "790911A",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Prime Focus Family Services
• Vivian D Prince, LLC
• Priority Health LLC
• Private Diagnostic Clinic, PLLC (High Point Regional Health System)
• Ricky Lee Proctor, ED.D., LAT, ATC
• Sophia Proscino
• Providence Place Assisted Living, Inc.
• Providence Place, LLC
• Providence Place, LLC
• Bobbie Pruitt

• Optometrist in High Point, NC
• Providers in High Point, NC by specialty
• Optometrist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2012; 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.