Southern Eye Care, O.D., PLLC

Primary specialty

OptometristTaxonomy code 152W00000X

License

1649 Issued in NC

Legal business name

SOUTHERN EYE CARE, O.D., PLLC

Practice address

2114 S Main St
Wake Forest, NC 27587-8817

Phone

(919) 271-4304

NPI assigned

Oct 13, 2014

Last updated

Oct 13, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Kris Janik Roy, D.O.NPI 1023321767

Title

Managing Member

Phone

(919) 271-4304

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Locations

Practitioners 1

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.

• Kris Janik Roy, O.D.

  • Optometrist
  • Wake Forest, NC
  • NPI 1023321767
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1413158400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1413158400000",
    "number": "1760886279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12441 BAYLEAF CHURCH RD",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276149168",
            "telephone_number": "919-271-4303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2114 S MAIN ST",
            "city": "WAKE FOREST",
            "state": "NC",
            "postal_code": "275878817",
            "telephone_number": "919-271-4304"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN EYE CARE, O.D., PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-13",
        "last_updated": "2014-10-13",
        "status": "A",
        "authorized_official_last_name": "ROY",
        "authorized_official_first_name": "KRIS",
        "authorized_official_middle_name": "JANIK",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "919-271-4304",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NC",
            "license": "1649",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carolyn Kay Solak, PA-C
• Sole Dimensions LLC
• Kristin Marie Somerville, DPT
• Laura Sotillo, LCSW
• Southern Assisted Living, LLC. (Brookdale Wake Forest)
• Shelley Marie Sparling, PT, DPT
• Katherine Spathelf, PT
• Joseph Spaulding Jr.
• Specialty Pharmacy Solutions LLC (Specialty Pharmacy Solutions)
• Speech Therapy Solutions

• Optometrist in Wake Forest, NC
• Providers in Wake Forest, NC by specialty
• Optometrist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2014; 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.