NPIMap

Organization Active NPI

Cape Fear Eye Associates PA

  • Ophthalmology Physician
  • Fayetteville, NC
National Provider Identifier
1962456343
Registry record updated Apr 25, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
CAPE FEAR EYE ASSOCIATES PA
Practice address
1726 Metro Medical Dr
Fayetteville, NC 28304-3861
Phone
(910) 484-2284
Fax
(910) 484-0458
NPI assigned
May 20, 2006
Last updated
Apr 25, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2012

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

Authorized official

Name
Pamela A Madison
Title
Credentialing Manager
Phone
(910) 484-2284

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X NU
Pediatric Optometrist 152WP0200X NU
Ophthalmology Physician 207W00000X NU Primary

Addresses

Primary practice location

1726 Metro Medical Dr
Fayetteville, NC 28304-3861

Mailing address

1726 Metro Medical Dr
Fayetteville, NC 28304-3861
Phone (910) 484-2284

Other identifiers 1

IdentifierTypeStateIssuer
890246FMedicaidNC

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20061013000091 NC Part B Supplier - Clinic/Group Practice 3072519107 Receives reassigned benefits from 12 practitioners
Practice locations: Fayetteville, NC

National Provider Directory

National Provider Directory

Locations

1629 Owen Dr
Ste 101
Fayetteville, NC 28304

1726 Metromedical Dr
Fayetteville, NC 28304
Phone (910) 484-2284

Practitioners & affiliated clinicians

Practitioners 12

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1148083200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1335312000000",
    "number": "1962456343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1726 METRO MEDICAL DR",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283043861",
            "telephone_number": "910-484-2284",
            "fax_number": "910-484-0458"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1726 METRO MEDICAL DR",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283043861",
            "telephone_number": "910-484-2284",
            "fax_number": "910-484-0458"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAPE FEAR EYE ASSOCIATES PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-20",
        "last_updated": "2012-04-25",
        "status": "A",
        "authorized_official_last_name": "MADISON",
        "authorized_official_first_name": "PAMELA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "910-484-2284"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "152WP0200X",
            "taxonomy_group": "",
            "desc": "Optometrist, Pediatrics",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "890246F",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2012; 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.