Stacie Ann Williams, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

2773 Issued in NC

Practice address

1737 Wilkesboro Hwy Ste D
Statesville, NC 28625-8602

Phone

(704) 878-2660

NPI assigned

May 18, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Specialty

Optometry

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Clark Optometric Center PAGroup PAC ID 6709911092, 45 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Clark Optometric Center PA

  • Optometrist
  • Durham, NC
  • NPI 1588619217
  Medicare reassignment Care Compare group NPD
• Bartlett Grigsby Boan & Assoc PLLC

  • Optometrist
  • Salisbury, NC
  • NPI 1013960517
  NPD (past)
• Clark Optometric Center of SC, P.a.

  • Optometrist
  • Simpsonville, SC
  • NPI 1063981900
  NPD (past)
• South Carolina CVS Pharmacy LLC

  • Pharmacy
  • Anderson, SC
  • NPI 1114020971
  NPD (past)

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

{
    "created_epoch": "1684368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697587200000",
    "number": "1932890084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1737 WILKESBORO HWY STE D",
            "city": "STATESVILLE",
            "state": "NC",
            "postal_code": "286258602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1737 WILKESBORO HWY STE D",
            "city": "STATESVILLE",
            "state": "NC",
            "postal_code": "286258602",
            "telephone_number": "704-878-2660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "STACIE",
        "middle_name": "ANN",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-18",
        "last_updated": "2023-10-18",
        "certification_date": "2023-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NC",
            "license": "2773",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• William J O'Neill
• Bre'Anna Nicole Williams, LCSW-A
• Hope Lynn Williams, LCMHC-A, LCAS-A
• Nan Plyler Williams, OTR/L
• Sarah Johnson Williams, MA/EDS, LPC, NCC
• Theresa Miller Williams, FNP-C
• Trinity Williams, LPN
• Mark Bascom Williamson, M.D.
• Exavier Danielle Wilson, LCSWA
• Gidget J. Wilson, RN

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.