Jerry N Ellington, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

1455 Issued in NC

Practice address

560 Dabney Drive
Henderson, NC 27536

Phone

(252) 438-6132

Fax

(252) 438-5161

NPI assigned

Jul 10, 2006

Last updated

Jan 11, 2013By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

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

Specialty

Optometry

Education

Pennsylvania College of Optometry, 1992

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Family Eye Center OD PAGroup PAC ID 3476608498, 3 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

77.3 of 100Reported as individual

Quality

53.31

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Family Eye Center OD PA

  • Optometrist
  • Henderson, NC
  • NPI 1457432577
  Medicare reassignment Care Compare group NPD
• Family Eye Center

  • Eyewear Supplier
  • Warrenton, NC
  • NPI 1053554147
  NPD (past)
• Mid-Atlantic Eye Physicians, PA

  • Ophthalmology Physician
  • Roanoke Rapids, NC
  • NPI 1215984331
  NPD (past)

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

{
    "created_epoch": "1152489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1357862400000",
    "number": "1740214188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "560 DABNEY DRIVE",
            "city": "HENDERSON",
            "state": "NC",
            "postal_code": "27536",
            "telephone_number": "252-438-6132",
            "fax_number": "252-438-5161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "560 DABNEY DRIVE",
            "city": "HENDERSON",
            "state": "NC",
            "postal_code": "27536",
            "telephone_number": "252-438-6132",
            "fax_number": "252-438-5161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLINGTON",
        "first_name": "JERRY",
        "middle_name": "N",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-10",
        "last_updated": "2013-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NC",
            "license": "1455",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8909180",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "890920F",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Meghan Ealy, OTR/L
• Amber Eberhart, PA-C
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• Edman Health Group PLLC
• Elitecare Virtual Solution
• Emmaus Puritan Apostolic Baptist (Emmaus Corp. Counseling Agency)
• Jennifer J Enevoldsen, LMSW, LCSW-P
• Katharine Elizabeth Engler, LMFT
• Envision Healthcare, Inc. (Barker Road Group Home)
• Mohammad Ali Esmaeil Pour, MD

• Optometrist in Henderson, NC
• Providers in Henderson, NC by specialty
• Optometrist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.