NPIMap

Organization Active NPI

Apex Vision Center OD PA

  • Optometrist
  • Apex, NC
National Provider Identifier
1730325473
Registry record updated Apr 17, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1711 Issued in NC
Legal business name
APEX VISION CENTER OD PA
Practice address
1049 Beaver Creek Commons Dr
Apex, NC 27502-3918
Phone
(919) 367-7889
Fax
(919) 249-4079
NPI assigned
Dec 31, 2008
Last updated
Apr 17, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2013

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

Authorized official

Name
David J HollerNPI 1184672859
Title
Optometrist
Phone
(919) 367-7889

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1711 NC Primary

Addresses

Primary practice location

1049 Beaver Creek Commons Dr
Apex, NC 27502-3918

Mailing address

1049 Beaver Creek Commons Dr
Apex, NC 27502-3918
Phone (919) 367-7889

Other identifiers 1

IdentifierTypeStateIssuer
5950746MedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090423000647 NC Part B Supplier - Clinic/Group Practice 5193873560 Receives reassigned benefits from 6 practitioners
Practice locations: Apex, NC

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 8

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": "1230681600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1366156800000",
    "number": "1730325473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1049 BEAVER CREEK COMMONS DR",
            "city": "APEX",
            "state": "NC",
            "postal_code": "275023918",
            "telephone_number": "919-367-7889",
            "fax_number": "919-249-4079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1049 BEAVER CREEK COMMONS DR",
            "city": "APEX",
            "state": "NC",
            "postal_code": "275023918",
            "telephone_number": "919-367-7889",
            "fax_number": "919-249-4079"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "APEX VISION CENTER OD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-12-31",
        "last_updated": "2013-04-17",
        "status": "A",
        "authorized_official_last_name": "HOLLER",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "919-367-7889"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NC",
            "license": "1711",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5950746",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Apex, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2013; 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.