NPIMap

Organization Active NPI

Spectrum Family Eye Center Optometric PA

  • Optometrist
  • Pinehurst, NC
National Provider Identifier
1912934704
Registry record updated Jun 21, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
SPECTRUM FAMILY EYE CENTER OPTOMETRIC PA
Practice address
160 Fox Hollow
Pinehurst, NC 28374
Phone
(910) 692-3937
Fax
(910) 692-5908
NPI assigned
Jun 27, 2006
Last updated
Jun 21, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2018

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

Authorized official

Name
Lorance Kennedy Burngarner, OD
Title
President
Phone
(910) 692-3937

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193200000X MULTI-SPECIALTY GROUP 152W00000X Primary

Addresses

Primary practice location

160 Fox Hollow
Pinehurst, NC 28374

Mailing address

160 Fox Hollow
Pinehurst, NC 28374
Phone (910) 692-3937

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050107000348 NC Part B Supplier - Clinic/Group Practice 0042268971 Receives reassigned benefits from 5 practitioners
Practice locations: Pinehurst, NC

National Provider Directory

National Provider Directory

Locations

1130 N Breazeale Ave
Ste D
Mount Olive, NC 28365
Phone (919) 658-0474

160 Fox Hollow Ct
Pinehurst, NC 28374
Phone (910) 692-3937

Practitioners & affiliated clinicians

Practitioners 12

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.

NPI Registry JSON

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

{
    "created_epoch": "1151366400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529539200000",
    "number": "1912934704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "160 FOX HOLLOW",
            "city": "PINEHURST",
            "state": "NC",
            "postal_code": "28374",
            "telephone_number": "910-692-3937",
            "fax_number": "910-692-5908"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "160 FOX HOLLOW",
            "city": "PINEHURST",
            "state": "NC",
            "postal_code": "28374",
            "telephone_number": "910-692-3937",
            "fax_number": "910-692-5908"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPECTRUM FAMILY EYE CENTER OPTOMETRIC PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-27",
        "last_updated": "2018-06-21",
        "status": "A",
        "authorized_official_last_name": "BURNGARNER",
        "authorized_official_first_name": "LORANCE",
        "authorized_official_middle_name": "KENNEDY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "910-692-3937",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pinehurst, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2018; 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.