Active NPI
Eyecarecenter OD PA
- Optometrist
- Charlotte, NC
National Provider Identifier
1780637181
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- Legal business name
- EYECARECENTER OD PA
- Practice address
- 1520 South Blvd Ste 105
Charlotte, NC 28203-4786 - Phone
- (704) 392-2020
- Fax
- (704) 399-8029
- NPI assigned
- May 18, 2006
- Last updated
- Sep 29, 2023
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Alison Bailey, OD
- Title
- Owner
- Phone
- (636) 200-4393
Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | Primary |
Addresses
Primary practice location
1520 South Blvd Ste 105
Charlotte, NC 28203-4786
Mailing address
PO Box 207261
Dallas, TX 75320-7261
Phone (636) 200-4393
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| CA8262 | Other | NC | RR MEDICARE GROUP |
| 02863 | Other | NC | BCBSNC GROUP NUMBER |
| 8902863 | Medicaid | NC |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NC
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040318001780 | NC | Part B Supplier - Clinic/Group Practice | 7315834462 |
Receives reassigned benefits from 137 practitioners 42 other NPIs on this enrollment This NPI is an additional NPI on the enrollment |
Other NPIs on the same Medicare enrollment 40
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
National Provider Directory
National Provider DirectoryLocations
1520 South Blvd
Ste 105
Charlotte, NC 28203
Phone (704) 392-2020
Practitioners & affiliated clinicians
Practitioners 3
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.
-
- Optometrist
- Charlotte, NC
- NPI 1043214844
-
- Optometrist
- Raleigh, NC
- NPI 1437970647
-
- Optometrist
- Charlotte, NC
- NPI 1003079518
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147910400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1695945600000",
"number": "1780637181",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 207261",
"city": "DALLAS",
"state": "TX",
"postal_code": "753207261",
"telephone_number": "636-200-4393",
"fax_number": "636-527-0766"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1520 SOUTH BLVD STE 105",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282034786",
"telephone_number": "704-392-2020",
"fax_number": "704-399-8029"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "EYECARECENTER OD PA",
"organizational_subpart": "NO",
"enumeration_date": "2006-05-18",
"last_updated": "2023-09-29",
"certification_date": "2023-09-29",
"status": "A",
"authorized_official_last_name": "BAILEY",
"authorized_official_first_name": "ALISON",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "636-200-4393",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "OD"
},
"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": "RR MEDICARE GROUP",
"identifier": "CA8262",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBSNC GROUP NUMBER",
"identifier": "02863",
"state": "NC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8902863",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Charlotte, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2023; 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.