Carl David Bollinger, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

1020 Issued in NC

Practice address

6301 Stadium Dr
B
Clemmons, NC 27012-8766

Phone

(336) 766-7373

Fax

(336) 766-7382

NPI assigned

Jan 15, 2007

Last updated

Jun 6, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 5

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1168819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686009600000",
    "number": "1922159169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 127",
            "city": "CLEMMONS",
            "state": "NC",
            "postal_code": "270120127",
            "telephone_number": "336-766-7373",
            "fax_number": "336-766-7382"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6301 STADIUM DR",
            "address_2": "B",
            "city": "CLEMMONS",
            "state": "NC",
            "postal_code": "270128766",
            "telephone_number": "336-766-7373",
            "fax_number": "336-766-7382"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLLINGER",
        "first_name": "CARL",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-15",
        "last_updated": "2023-06-06",
        "certification_date": "2023-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NC",
            "license": "1020",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SPECTERA",
            "identifier": "13283",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "09114",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EYEMED VISION CARE",
            "identifier": "917812",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "561282758",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PALMETTO",
            "identifier": "0952390001",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• James William Bodie Jr., RPH
• Bodycare Chiropractic Inc
• Lauren Boehnlein
• Nancy Elizabeth Bogenrieder, APRN, FNP-C
• Benjamin Keith Boles, PA-C
• Aubrey Gayle Boos
• Holly Antony Borders, M.D.
• Jessica Diane Born, FNP
• Margo Born, CD,DONA
• Leslie Jean Boucherle, PA-C

• Optometrist in Clemmons, NC
• Providers in Clemmons, NC by specialty
• Optometrist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.