Willard L McCloud Jr., MD

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

24685 Issued in NC

Practice address

204 Becker Dr
Roanoke Rapids, NC 27870-3134

Phone

(252) 537-8193

Fax

(252) 537-0589

NPI assigned

Jan 29, 2007

Last updated

Nov 11, 2020By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in VA, NC2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Ophthalmology

Education

Meharry Medical College School of Medicine, 1977

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mid-Atlantic Eye Physicians PAGroup PAC ID 4880672815, 2 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

90.9 of 100Reported as group

Quality

100

Promoting interoperability

100

Improvement activities

40

Cost

69.67

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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

• Mid-Atlantic Eye Physicians, PA

  • Ophthalmology Physician
  • Roanoke Rapids, NC
  • NPI 1215984331

  VA

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1170028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605052800000",
    "number": "1891831905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "204 BECKER DR",
            "city": "ROANOKE RAPIDS",
            "state": "NC",
            "postal_code": "278703134",
            "telephone_number": "252-537-8193",
            "fax_number": "252-537-0589"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "204 BECKER DR",
            "city": "ROANOKE RAPIDS",
            "state": "NC",
            "postal_code": "278703134",
            "telephone_number": "252-537-8193",
            "fax_number": "252-537-0589"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "620 Dunleith Ave",
            "address_purpose": "LOCATION",
            "city": "Winston Salem",
            "state": "NC",
            "postal_code": "271013374",
            "country_code": "US",
            "telephone_number": "336-759-2257",
            "fax_number": "336-759-7778",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCCLOUD",
        "first_name": "WILLARD",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-29",
        "last_updated": "2020-11-11",
        "certification_date": "2020-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NC",
            "license": "24685",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8955819",
            "state": "NC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "willard.mccloud.p1@direct.maep.nextgenshare.com",
            "affiliation": "N",
            "address_1": "204 Becker Dr",
            "city": "Roanoke Rapids",
            "state": "NC",
            "country_code": "US",
            "postal_code": "278703134",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Silviano Joseph Mastromarino, DDS
• Jennifer Tetterton May, ANP
• Teresa C Mayle, MSRC, LPCA
• Brian Lanier Maynor, DDS
• Starr Monique McCall
• Danielle McGee, PHARM D
• Thomas Allen Mebane, OD
• Med First Immediate Care & Family Practice PA
• Thomas Medlin
• Alana Cahoon Meyers, MSW, LCSW

• Ophthalmology Physician in Roanoke Rapids, NC
• Providers in Roanoke Rapids, NC by specialty
• Ophthalmology Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.