Individual provider Active NPI

Cynthia Collie Rohm, O.D.

  • Optometrist
  • Raleigh, NC
National Provider Identifier
1891716148
Registry record updated Apr 30, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1124 Issued in NC
Practice address
4325 Glenwood Ave
Raleigh, NC 27612-4532
Phone
(919) 782-4100
Fax
(919) 787-9573
NPI assigned
Jul 22, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1124 NC Primary

Addresses

Primary practice location

4325 Glenwood Ave
Raleigh, NC 27612-4532

Mailing address

4325 Glenwood Ave
Raleigh, NC 27612-4532
Phone (919) 782-4100

Other identifiers 2

IdentifierTypeStateIssuer
0908POtherNCBCBS INDIVIDUAL
5908669MedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050304000746 NC Practitioner - Optometry 8527012202 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pennsylvania College of Optometry, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Eyecarecenter OD PAGroup PAC ID 7315834462, 71 clinicians

Practice addresses (Care Compare)

4325 Glenwood Ave
Raleigh, NC 27612-4532
Phone (919) 782-4100

819 Tiffany Blvd
Rocky Mount, NC 27804-1812
Phone (252) 972-2020

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1124NCMDAthletic Trainer

Practice roles

OrganizationSpecialtyStatusNew patients
Eyecarecenter, O.D., P.a. Optometrist CurrentSince Aug 1, 1995 Accepting new patients
Eyecarecenter OD PA Optometrist CurrentSince Aug 1, 1995 Accepting new patients
Eyecarecenter OD PA Optometrist Current Accepting new patients
C.V. Sikes,Jr. & R.B. Gotschalk PTR Optometrist Past Accepting new patients

Locations

4325 Glenwood Ave
Raleigh, NC 27612
Phone (919) 782-4100

819 Tiffany Blvd
Rocky Mount, NC 27804
Phone (252) 972-2020

Interoperability endpoints

  • Direct secure messaging: crohm@direct.eyecare-partners.com

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1153526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1209513600000",
    "number": "1891716148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4325 GLENWOOD AVE",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276124532",
            "telephone_number": "919-782-4100",
            "fax_number": "919-787-9573"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4325 GLENWOOD AVE",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276124532",
            "telephone_number": "919-782-4100",
            "fax_number": "919-787-9573"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROHM",
        "first_name": "CYNTHIA",
        "middle_name": "COLLIE",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-22",
        "last_updated": "2008-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NC",
            "license": "1124",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS INDIVIDUAL",
            "identifier": "0908P",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5908669",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

Verify at the official NPI Registry.