Organization Active NPI

Piedmont Eye Center, P.a.

  • Ophthalmology Physician
  • Greensboro, NC
National Provider Identifier
1760545792
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
PIEDMONT EYE CENTER, P.A.
Practice address
3810 N Elm St
Suite 209
Greensboro, NC 27455-2727
Phone
(336) 282-3940
Fax
(336) 282-8404
NPI assigned
Dec 19, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Samuel Lester Tyson, M.D.
Title
Ophthalmologist
Phone
(336) 282-3940

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207W00000X Primary

Addresses

Primary practice location

3810 N Elm St
Suite 209
Greensboro, NC 27455-2727

Mailing address

3810 N Elm St
Suite 209
Greensboro, NC 27455-2727
Phone (336) 282-3940

Other identifiers 1

IdentifierTypeStateIssuer
890257XMedicaidNC

National Provider Directory

National Provider Directory

Locations

3810 N Elm St
Ste 209
Greensboro, NC 27455
Phone (336) 282-3940

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1166486400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1760545792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3810 N ELM ST",
            "address_2": "SUITE 209",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274552727",
            "telephone_number": "336-282-3940",
            "fax_number": "336-282-8404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3810 N ELM ST",
            "address_2": "SUITE 209",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274552727",
            "telephone_number": "336-282-3940",
            "fax_number": "336-282-8404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PIEDMONT EYE CENTER, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-19",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "TYSON",
        "authorized_official_first_name": "SAMUEL",
        "authorized_official_middle_name": "LESTER",
        "authorized_official_title_or_position": "OPHTHALMOLOGIST",
        "authorized_official_telephone_number": "336-282-3940",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "890257X",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greensboro, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.