Kernersville Eye Associates, O.D., P.a.

Primary specialty

OptometristTaxonomy code 152W00000X

License

2006 Issued in NC

Legal business name

KERNERSVILLE EYE ASSOCIATES, O.D., P.A.

Practice address

1030 S Main St
Suite Q
Kernersville, NC 27284-7490

Phone

(336) 992-0010

Fax

(336) 245-4636

NPI assigned

Feb 2, 2010

Organization subpart

No

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

Authorized official

Name

Dr. Arun T Subramanian, O.D., F.A.A.O.NPI 1538129291

Title

Owner

Phone

(336) 992-0010

Specialties & licenses 1

Addresses

Other identifiers 6

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Tax ID family

Kernersville Eye Associates2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Kernersville Eye Associates, OD PA

  • Optometrist
  • Lexington, NC
  • NPI 1083044549
  NPD tax ID

Locations

Practitioners 1

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

• Arun Thoppe Subramanian, OD FAAO

  • Optometrist
  • Kernersville, NC
  • NPI 1538129291
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1265068800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1599091200000",
    "number": "1770815722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1635 NC HIGHWAY 66 S STE 155",
            "city": "KERNERSVILLE",
            "state": "NC",
            "postal_code": "272843855",
            "telephone_number": "336-992-0010",
            "fax_number": "336-245-4636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1030 S MAIN ST",
            "address_2": "SUITE Q",
            "city": "KERNERSVILLE",
            "state": "NC",
            "postal_code": "272847490",
            "telephone_number": "336-992-0010",
            "fax_number": "336-245-4636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KERNERSVILLE EYE ASSOCIATES, O.D., P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-02-02",
        "last_updated": "2020-09-03",
        "certification_date": "2020-09-03",
        "status": "A",
        "authorized_official_last_name": "SUBRAMANIAN",
        "authorized_official_first_name": "ARUN",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "336-992-0010",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D., F.A.A.O."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "NC",
            "license": "2006",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5905630",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA US HEALTHCARE",
            "identifier": "7866788",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PARTNERS NATIONAL HEALTH PLAN",
            "identifier": "807938",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF NC",
            "identifier": "093U1",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "2630870",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PALMETTO GBA RAILROAD MEDICARE",
            "identifier": "P00450033",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Levi Alan Kerby, PT DPT
• Kerner Ridge Assisted Living LLC
• Kernersville Chiropractic Center
• Kernersville Counseling Center PLLC
• Kernersville Emergency Group, PLLC
• Kernersville Eye Surgeons, PC
• Kernersville Pharmacy LLC
• Kernersville Pharmacy LLC
• Kernersville Rehab Specialists LLC
• Mary Kerr

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2020; 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.