Individual provider Active NPI

Crystal M Brimer, O.D

  • Optometrist
  • Wilmington, NC
National Provider Identifier
1922189844
Registry record updated May 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
NC1811 Issued in NC
Practice address
710 Military Cutoff Road
Suite 130
Wilmington, NC 28405-2382
Phone
(910) 447-2020
Fax
(866) 984-3914
NPI assigned
Oct 18, 2006
Last updated
May 12, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 12, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X NC1811 NC Primary

Addresses

Primary practice location

710 Military Cutoff Road
Suite 130
Wilmington, NC 28405-2382

Mailing address

710 Military Cutoff Road
Suite 130
Wilmington, NC 28405-2382
Phone (910) 447-2020

Other identifiers 6

IdentifierTypeStateIssuer
2200298OtherNCUHC ID #
89093KFMedicaidNC
014PAOtherNCBCBS
014PAOtherNCBCBS PROVIDER ID
B8413OtherNCMEDCOST PROVIDER #
89014TCMedicaidNC

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
I20101201000992 NC Practitioner - Optometry 7012953003 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

710 Military Cutoff Rd
Suite 130
Wilmington, NC 28405-2382
Phone (910) 447-2020

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1811NCMDMarriage & Family Therapist
NC1811NCMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Steve M. Shelton O.D. Optometrist Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: focuseyecare.crystalbrimer@144582.advancedmd-direct.com

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1161129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683849600000",
    "number": "1922189844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "710 MILITARY CUTOFF ROAD",
            "address_2": "SUITE 130",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284052382",
            "telephone_number": "910-447-2020",
            "fax_number": "866-984-3914"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "710 MILITARY CUTOFF ROAD",
            "address_2": "SUITE 130",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284052382",
            "telephone_number": "910-447-2020",
            "fax_number": "866-984-3914"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRIMER",
        "first_name": "CRYSTAL",
        "middle_name": "M",
        "name_prefix": "Ms.",
        "credential": "O.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-18",
        "last_updated": "2023-05-12",
        "certification_date": "2023-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NC",
            "license": "NC1811",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UHC ID #",
            "identifier": "2200298",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89093KF",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "014PA",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER ID",
            "identifier": "014PA",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDCOST PROVIDER #",
            "identifier": "B8413",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89014TC",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, NC

Sources for this page

Verify at the official NPI Registry.