Organization Active NPI

Wise Eyes Family Eye Care, OD, PLLC

  • Optometrist
  • Winston Salem, NC
National Provider Identifier
1922611342
Registry record updated Oct 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
WISE EYES FAMILY EYE CARE, OD, PLLC
Practice address
631 Coliseum Dr Ste 102
Winston Salem, NC 27106-5310
Phone
(336) 830-8061
Fax
(336) 830-8162
NPI assigned
Aug 25, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2020

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

Authorized official

Name
Dr. Lindsay Totten, OD
Title
Optometrist/Owner
Phone
(336) 260-8586

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X Primary

Addresses

Primary practice location

631 Coliseum Dr Ste 102
Winston Salem, NC 27106-5310

Mailing address

631 Coliseum Dr Ste 102
Winston Salem, NC 27106-5310
Phone (336) 830-8061

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://revolutionehr.com/static/#/

National Provider Directory

National Provider Directory

Locations

631 Coliseum Dr
Ste 102
Winston Salem, NC 27106
Phone (336) 469-8828

NPI Registry JSON

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

{
    "created_epoch": "1598313600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1601942400000",
    "number": "1922611342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "631 COLISEUM DR STE 102",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271065310",
            "telephone_number": "336-830-8061",
            "fax_number": "336-830-8162"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "631 COLISEUM DR STE 102",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271065310",
            "telephone_number": "336-830-8061",
            "fax_number": "336-830-8162"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WISE EYES FAMILY EYE CARE, OD, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-08-25",
        "last_updated": "2020-10-06",
        "certification_date": "2020-10-06",
        "status": "A",
        "authorized_official_last_name": "TOTTEN",
        "authorized_official_first_name": "LINDSAY",
        "authorized_official_title_or_position": "OPTOMETRIST/OWNER",
        "authorized_official_telephone_number": "336-260-8586",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://revolutionehr.com/static/#/",
            "affiliation": "N",
            "address_1": "631 Coliseum Dr Ste 102",
            "city": "Winston Salem",
            "state": "NC",
            "country_code": "US",
            "postal_code": "271065310",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Winston Salem, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.