Kernersville Eye Surgeons, PC

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

Legal business name

KERNERSVILLE EYE SURGEONS, PC

Practice address

210 N Main St Ste 144
Kernersville, NC 27284-4003

Phone

(336) 992-9637

Fax

(336) 992-9638

NPI assigned

Jun 10, 2010

Organization subpart

No

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

Authorized official

Name

Patrick A HagemanNPI 1629059860

Title

President

Phone

(336) 992-9637

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

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

Interoperability endpoints

• Direct secure messaging: kmurdock@kes.intellechartdirect.net
• Direct secure messaging: phageman@kes.intellechartdirect.net

Practitioners 3

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

• Patrick A Hageman, M.D.

  • Ophthalmology Physician
  • Kernersville, NC
  • NPI 1629059860
  Medicare reassignment Care Compare group NPD Authorized official
• Kirk A Murdock, MD

  • Ophthalmology Physician
  • Kernersville, NC
  • NPI 1164426730
  Medicare reassignment Care Compare group NPD
• Renn Lovett, MD

  • Ophthalmology Physician
  • Kernersville, NC
  • NPI 1356082531
  NPD (past)

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

{
    "created_epoch": "1276128000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1709337600000",
    "number": "1750601803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 N MAIN ST STE 144",
            "city": "KERNERSVILLE",
            "state": "NC",
            "postal_code": "272844003",
            "telephone_number": "336-992-9637",
            "fax_number": "336-992-9638"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 N MAIN ST STE 144",
            "city": "KERNERSVILLE",
            "state": "NC",
            "postal_code": "272844003",
            "telephone_number": "336-992-9637",
            "fax_number": "336-992-9638"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KERNERSVILLE EYE SURGEONS, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-06-10",
        "last_updated": "2024-03-02",
        "certification_date": "2024-03-02",
        "status": "A",
        "authorized_official_last_name": "HAGEMAN",
        "authorized_official_first_name": "PATRICK",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "336-992-9637"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "phageman@kernersvilleeyesurgeons.imwdirect.com",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "210 N Main St Ste 144",
            "city": "Kernersville",
            "state": "NC",
            "country_code": "US",
            "postal_code": "272844003",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Kerner Ridge Assisted Living LLC
• Kernersville Chiropractic Center
• Kernersville Counseling Center PLLC
• Kernersville Emergency Group, PLLC
• Kernersville Eye Associates, O.D., P.a.
• Kernersville Pharmacy LLC (Kernersville Pharmacy)
• Kernersville Pharmacy LLC (Kernersville Pharmacy)
• Kernersville Rehab Specialists LLC
• Mary Kerr
• Jalaal Malik Khan, PA

• Ophthalmology Physician in Kernersville, NC
• Providers in Kernersville, 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 Mar 2, 2024; 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.