Organization Active NPI

Laser Eye Institute PA

  • Ophthalmic Technician/Technologist
  • Laurinburg, NC
National Provider Identifier
1952461840
Registry record updated Mar 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmic Technician/TechnologistTaxonomy code 156FX1100X
License
207W00000X Issued in NC
Legal business name
LASER EYE INSTITUTE PA
Practice address
1603 Medical Dr Ste D
Laurinburg, NC 28352-5541
Phone
(910) 277-1411
NPI assigned
Dec 11, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2023

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

Authorized official

Name
Wanda Dee Marcum
Title
Office Manager
Phone
(910) 277-1411

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmic Technician/TechnologistGroup: 193400000X SINGLE SPECIALTY GROUP 156FX1100X 207W00000X NC Primary

Addresses

Primary practice location

1603 Medical Dr Ste D
Laurinburg, NC 28352-5541

Mailing address

1603 Medical Dr Ste D
Laurinburg, NC 28352-5541

Other identifiers 3

IdentifierTypeStateIssuer
8911517MedicaidNC
N00585MedicaidSC
0109AOtherNCBCBS OF NC

Other names 1

  • THE LASER EYE INSTITUTE Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080108000561 NC Part B Supplier - Clinic/Group Practice 9335229962 Receives reassigned benefits from 1 practitioner
Practice locations: Laurinburg, NC

National Provider Directory

National Provider Directory

Locations

1603 Medical Dr
Ste D
Laurinburg, NC 28352
Phone (910) 277-1411

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1165795200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678665600000",
    "number": "1952461840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1603 MEDICAL DR STE D",
            "city": "LAURINBURG",
            "state": "NC",
            "postal_code": "283525541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1603 MEDICAL DR STE D",
            "city": "LAURINBURG",
            "state": "NC",
            "postal_code": "283525541",
            "telephone_number": "910-277-1411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LASER EYE INSTITUTE PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-11",
        "last_updated": "2023-03-13",
        "certification_date": "2023-03-13",
        "status": "A",
        "authorized_official_last_name": "MARCUM",
        "authorized_official_first_name": "WANDA",
        "authorized_official_middle_name": "DEE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "910-277-1411"
    },
    "taxonomies": [
        {
            "code": "156FX1100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Technician/Technologist, Ophthalmic",
            "state": "NC",
            "license": "207W00000X",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8911517",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "N00585",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF NC",
            "identifier": "0109A",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "THE LASER EYE INSTITUTE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Laurinburg, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2023; 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.