NPIMap

Organization Active NPI

Myeyedr Optometry of North Carolina PLLC

  • Optometrist
  • Greensboro, NC
National Provider Identifier
1962460170
Registry record updated May 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
MYEYEDR OPTOMETRY OF NORTH CAROLINA PLLC
Practice address
5710 Gate City Blvd
Suite Q
Greensboro, NC 27407-7065
Phone
(336) 856-8711
Fax
(336) 856-0498
NPI assigned
May 4, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 29, 2022

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

Authorized official

Name
Sue Healey
Title
Secretary
Phone
(703) 847-8899

Specialties & licenses 1

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

Addresses

Primary practice location

5710 Gate City Blvd
Suite Q
Greensboro, NC 27407-7065

Mailing address

8614 Westwood Center Dr FL 9
Vienna, VA 22182-2442
Phone (703) 847-8899

Other identifiers 3

IdentifierTypeStateIssuer
011W8OtherNCBCBS GRP #
89011W8MedicaidNC
CJ4427OtherNCRR MEDICARE GROUP #

Other names 1

  • MyEyeDr Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130904000726 NC Part B Supplier - Clinic/Group Practice 6608019096 Receives reassigned benefits from 258 practitioners
This NPI is an additional NPI on the enrollment

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 12

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": "1146700800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1653782400000",
    "number": "1962460170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8614 WESTWOOD CENTER DR FL 9",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221822442",
            "telephone_number": "703-847-8899",
            "fax_number": "571-223-6780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5710 GATE CITY BLVD",
            "address_2": "SUITE Q",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274077065",
            "telephone_number": "336-856-8711",
            "fax_number": "336-856-0498"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MYEYEDR OPTOMETRY OF NORTH CAROLINA PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-04",
        "last_updated": "2022-05-29",
        "certification_date": "2022-05-29",
        "status": "A",
        "authorized_official_last_name": "HEALEY",
        "authorized_official_first_name": "SUE",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "703-847-8899"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS GRP #",
            "identifier": "011W8",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89011W8",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE GROUP #",
            "identifier": "CJ4427",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MyEyeDr",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "MyEyeDr",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Greensboro, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2022; 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.