NPIMap

Organization Active NPI

Cary Optometric, PA

  • Optometrist
  • Cary, NC
National Provider Identifier
1710157623
Registry record updated Sep 20, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1183 Issued in NC
Legal business name
CARY OPTOMETRIC, PA
Practice address
160 NE Maynard Rd
Suite 110
Cary, NC 27513
Phone
(919) 439-7995
Fax
(919) 415-0422
NPI assigned
Mar 6, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2013

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

Authorized official

Name
Dr. Marcia Dettloff, O.D.
Title
President
Phone
(919) 439-7995

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 1183 NC Primary

Addresses

Primary practice location

160 NE Maynard Rd
Suite 110
Cary, NC 27513

Mailing address

160 NE Maynard Rd
Suite 110
Cary, NC 27513
Phone (919) 439-7995

National Provider Directory

National Provider Directory

Locations

10479 N NC Highway 109
Ste B
Winston Salem, NC 27107

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1204761600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1379635200000",
    "number": "1710157623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "160 NE MAYNARD RD",
            "address_2": "SUITE 110",
            "city": "CARY",
            "state": "NC",
            "postal_code": "27513",
            "telephone_number": "919-439-7995",
            "fax_number": "919-415-0422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "160 NE MAYNARD RD",
            "address_2": "SUITE 110",
            "city": "CARY",
            "state": "NC",
            "postal_code": "27513",
            "telephone_number": "919-439-7995",
            "fax_number": "919-415-0422"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARY OPTOMETRIC, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-06",
        "last_updated": "2013-09-20",
        "status": "A",
        "authorized_official_last_name": "DETTLOFF",
        "authorized_official_first_name": "MARCIA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "919-439-7995",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "NC",
            "license": "1183",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cary, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.