Davis Ophthalmology, PLLC

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

201700503 Issued in NC

Legal business name

DAVIS OPHTHALMOLOGY, PLLC

Practice address

408 8TH St Ste 2
North Wilkesboro, NC 28659-4167

Phone

(336) 838-5121

Fax

(336) 667-5756

NPI assigned

Jul 11, 2018

Last updated

Mar 7, 2023By 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. Ronald Tyler Davis, DONPI 1104169366

Title

Registered Agent/Owner

Phone

(336) 838-5121

Specialties & licenses 1

Addresses

Other identifiers 3

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.

• Ronald Tyler Davis, D.O.

  • Ophthalmology Physician
  • North Wilkesboro, NC
  • NPI 1104169366
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1531267200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1902382146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "408 8TH ST STE 2",
            "city": "NORTH WILKESBORO",
            "state": "NC",
            "postal_code": "286594167",
            "telephone_number": "336-838-5121",
            "fax_number": "336-667-5756"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "408 8TH ST STE 2",
            "city": "NORTH WILKESBORO",
            "state": "NC",
            "postal_code": "286594167",
            "telephone_number": "336-838-5121",
            "fax_number": "336-667-5756"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVIS OPHTHALMOLOGY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-07-11",
        "last_updated": "2023-03-07",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "RONALD",
        "authorized_official_middle_name": "TYLER",
        "authorized_official_title_or_position": "REGISTERED AGENT/OWNER",
        "authorized_official_telephone_number": "336-838-5121",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NC",
            "license": "201700503",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PECOS",
            "identifier": "1456663889",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "19SQD",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "14007221",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• April Dawn Croston, FNP
• Cultivate Physical Therapy & Performance LLC
• Caitlyn Daly, DMD
• Melissa Kristina Darcy, LCSWA
• Briteny Nichole Darnell-Greene
• Amber Nicole Davis, RN
• Bethany Davis, M.S.
• Cody Hamilton Davis, D.O.
• Laura Newman Davis, SLP
• Melissa Cook Davis, PA-C

• Ophthalmology Physician in North Wilkesboro, NC
• Providers in North Wilkesboro, 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 Mar 7, 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.

Verify at the official NPI Registry.