Dexter Wayne Street, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

1375 Issued in NC

Practice address

913 Worth St
Mount Airy, NC 27030-4459

Phone

(336) 786-8828

Fax

(336) 786-5977

NPI assigned

Apr 4, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 5

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

Pennsylvania College of Optometry, 1984

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Oliver Optometric Eye CareGroup PAC ID 3971885443, 3 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Oliver Optometric Eye Care

  • Optometrist
  • Sparta, NC
  • NPI 1629528104
  Medicare reassignment Care Compare group NPD
• Keith Oliver Dr

  • Optometrist
  • Sparta, NC
  • NPI 1851579056
  NPD (past)
• Schonhofen Optometry PA

  • Optometrist
  • Elkin, NC
  • NPI 1407814122
  NPD (past)

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

{
    "created_epoch": "1144108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1322611200000",
    "number": "1962464156",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "913 WORTH ST",
            "city": "MOUNT AIRY",
            "state": "NC",
            "postal_code": "270304459",
            "telephone_number": "336-786-8828",
            "fax_number": "336-786-5977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "913 WORTH ST",
            "city": "MOUNT AIRY",
            "state": "NC",
            "postal_code": "270304459",
            "telephone_number": "336-786-8828",
            "fax_number": "336-786-5977"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STREET",
        "first_name": "DEXTER",
        "middle_name": "WAYNE",
        "name_prefix": "Mr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-04",
        "last_updated": "2011-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NC",
            "license": "1375",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "431657",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "09878",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7909878",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "410038739",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "2208005",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Roger Dale Stamper
• Katie Lynn Starling, PA-C
• John Michael Stevens, PT, DPT
• Leslie Marie Stoklosa, DC
• Brittany Knicely Street, NP
• Angela Conley Stroup, OT/L
• David R Stull, CRNA
• Haley McCoin Sullivan, LCSWA
• Beale M Sumner Jr., DDS
• Beale McKenzie Sumner III, DDS

• Optometrist in Mount Airy, NC
• Providers in Mount Airy, NC by specialty
• Optometrist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2011; 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.