Patty Vision Center OD PA

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

PATTY VISION CENTER OD PA

Practice address

415 Semora Rd
Roxboro, NC 27573-5185

Phone

(336) 599-0246

Fax

(336) 597-3356

NPI assigned

Jan 10, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Augusta Reid Patty Jr.

Title

Optometrist

Phone

(336) 599-0246

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Other NPIs on the same Medicare enrollment 3

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Patty Vision Center OD PA

  • Optometrist
  • Yanceyville, NC
  • NPI 1497798177

  O20040724000414

  Same enrollment
• Patty Vision Center OD PA

  • Optometrist
  • Burlington, NC
  • NPI 1548217755

  O20040724000414

  Same enrollment
• Patty Vision Center OD PA

  • Optometrist
  • Mebane, NC
  • NPI 1598277402

  O20040724000414

  Same enrollment

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

CLIA laboratory certificates

Locations

Practitioners 2

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

• Jingya Jeanne Chen

  • Optometrist
  • Roxboro, NC
  • NPI 1295132520
  NPD (past)
• Michael Marino, OD

  • Optometrist
  • Apex, NC
  • NPI 1326097601
  NPD (past)

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

{
    "created_epoch": "1168387200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1407974400000",
    "number": "1740339449",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 SEMORA RD",
            "city": "ROXBORO",
            "state": "NC",
            "postal_code": "275735185",
            "telephone_number": "336-599-0246",
            "fax_number": "336-597-3356"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 SEMORA RD",
            "city": "ROXBORO",
            "state": "NC",
            "postal_code": "275735185",
            "telephone_number": "336-599-0246",
            "fax_number": "336-597-3356"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PATTY VISION CENTER OD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-10",
        "last_updated": "2014-08-14",
        "status": "A",
        "authorized_official_last_name": "PATTY",
        "authorized_official_first_name": "AUGUSTA",
        "authorized_official_middle_name": "REID",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "336-599-0246",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PIN",
            "identifier": "014C5",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5915918",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jonelle Denise Palmer
• Paragon Outpatient Rehabilitation Services, LLC
• Amanda Patanio, COTA
• Neha Patel, PHARMD
• Sonalee Patel, PA-C
• Ricky Paylor, LCAS
• PCGH, Inc
• PCGH, Inc
• PCGH, Inc
• PCGH, Inc

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2014; 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.