Buena Vista Eye PC

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

9800734 Issued in NC

Legal business name

BUENA VISTA EYE PC

Practice address

1214 Reynolda Rd
Suite a
Winston Salem, NC 27104-1122

Phone

(336) 723-2555

Fax

(336) 723-9007

NPI assigned

Nov 8, 2005

Organization subpart

No

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

Authorized official

Name

Mrs. Amy Barta Wall, MDNPI 1922297654

Title

President

Phone

(336) 723-2555

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Locations

Practitioners 1

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

• Amy Barta Wall, M.D.

  • Ophthalmology Physician
  • Winston Salem, NC
  • NPI 1922297654
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1131408000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1288742400000",
    "number": "1720069693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1214 REYNOLDA RD",
            "address_2": "SUITE A",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271041122",
            "telephone_number": "336-723-2555",
            "fax_number": "336-723-9007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1214 REYNOLDA RD",
            "address_2": "SUITE A",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271041122",
            "telephone_number": "336-723-2555",
            "fax_number": "336-723-9007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BUENA VISTA EYE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-08",
        "last_updated": "2010-11-03",
        "status": "A",
        "authorized_official_last_name": "WALL",
        "authorized_official_first_name": "AMY",
        "authorized_official_middle_name": "BARTA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "336-723-2555",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "NC",
            "license": "9800734",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "012T3",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89012T3",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Payton E Bryant, RN
• Victoria Bryant
• BT Heart and Vascular Center, PLLC
• Diana Bucio
• Kelsey Robert Budd, M.D.
• Rachal Buffington
• Amie Anderson Buffkin, RN
• Gregory Michael Bugaj, MD
• Kristine Michelle Bugajski, RPSGT CCSH
• Jamie Anne Buhagiar, FNP

• Ophthalmology Physician in Winston Salem, NC
• Providers in Winston Salem, NC by specialty
• Ophthalmology Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2010; 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.