Individual provider Active NPI

Tracy Jo Waner, O.D.

  • Optometrist
  • Morehead City, NC
National Provider Identifier
1700076700
Registry record updated Aug 3, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2102 Issued in NC
Practice address
300 Hwy 24
Morehead City, NC 28557-2551
Phone
(252) 622-4358
NPI assigned
Jul 26, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 5752 OH
Optometrist 152W00000X 2102 NC Primary

Addresses

Primary practice location

300 Hwy 24
Morehead City, NC 28557-2551

Mailing address

1002 Linda CT
Newport, NC 28570-9349
Phone (252) 622-4358

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
I20100804001155 NC Practitioner - Optometry 0749313260 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Ohio State University - College of Optometry, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Waner Family Eye Care O.D., PLLCGroup PAC ID 2769569805, 2 clinicians

Practice addresses (Care Compare)

300 NC Hwy 24
Morehead City, NC 28557-2551
Phone (252) 622-4358

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2102NCMDMarriage & Family Therapist
5752OHMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Waner Family Eye Care O.D., PLLC Optometrist CurrentSince Jun 20, 2010 Accepting new patients

Locations

300 NC Highway 24
Morehead City, NC 28557
Phone (252) 247-0511

Organizations & group practices 1

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": "1185408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1312329600000",
    "number": "1700076700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1002 LINDA CT",
            "city": "NEWPORT",
            "state": "NC",
            "postal_code": "285709349",
            "telephone_number": "252-622-4358"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 HWY 24",
            "city": "MOREHEAD CITY",
            "state": "NC",
            "postal_code": "285572551",
            "telephone_number": "252-622-4358"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WANER",
        "first_name": "TRACY",
        "middle_name": "JO",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-26",
        "last_updated": "2011-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "5752",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NC",
            "license": "2102",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Morehead City, NC

Sources for this page

Verify at the official NPI Registry.