Organization Active NPI

Aldridge Eye Institute, OD, PA

  • Optometrist
  • Burnsville, NC
National Provider Identifier
1710176979
Registry record updated Nov 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1015 Issued in NC
Legal business name
ALDRIDGE EYE INSTITUTE, OD, PA
Practice address
419 E Main St
Burnsville, NC 28714-3050
Phone
(828) 682-2104
Fax
(828) 682-4217
NPI assigned
Oct 23, 2007
Last updated
Nov 8, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2022

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

Authorized official

Name
Eileen Marie Black
Title
Insurance Coordinator
Phone
(828) 682-2104

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1015 NC Primary

Addresses

Primary practice location

419 E Main St
Burnsville, NC 28714-3050

Mailing address

PO Box 218
419 East Main Street
Burnsville, NC 28714-0218
Phone (828) 682-2104

Other identifiers 4

IdentifierTypeStateIssuer
09016OtherNCBLUE CROSS BLUE SHIELD
5950031MedicaidNC
7909016MedicaidNC
5909234MedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20050531000206 NC Part B Supplier - Clinic/Group Practice 1456393537 Receives reassigned benefits from 2 practitioners
Practice locations: Burnsville, NC
O20100930088220 NC DME Supplier - Physician - OptometristDME Supplier - Optician 1456393537 Practice locations: Burnsville, NC

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Aldridge Eye Institute, OD, PA419 E Main St, Burnsville, NC 28714-0218(828) 682-2104 Prosthetic Lenses: Conventional Eyeglasses Accepts assignmentParticipating since Jun 1, 2005

National Provider Directory

National Provider Directory

Locations

419 E Main St
Burnsville, NC 28714
Phone (828) 678-9100

Practitioners & affiliated clinicians

Practitioners 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1193097600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1667865600000",
    "number": "1710176979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 218",
            "address_2": "419 EAST MAIN STREET",
            "city": "BURNSVILLE",
            "state": "NC",
            "postal_code": "287140218",
            "telephone_number": "828-682-2104",
            "fax_number": "828-682-4217"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "419 E MAIN ST",
            "city": "BURNSVILLE",
            "state": "NC",
            "postal_code": "287143050",
            "telephone_number": "828-682-2104",
            "fax_number": "828-682-4217"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALDRIDGE EYE INSTITUTE, OD, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-23",
        "last_updated": "2022-11-08",
        "certification_date": "2021-04-05",
        "status": "A",
        "authorized_official_last_name": "BLACK",
        "authorized_official_first_name": "EILEEN",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "INSURANCE COORDINATOR",
        "authorized_official_telephone_number": "828-682-2104"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NC",
            "license": "1015",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "09016",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5950031",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7909016",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5909234",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Burnsville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.