NPIMap

Organization Active NPI

North Carolina Eye Ear Nose & Throat PA

  • Ophthalmology Physician
  • Durham, NC
National Provider Identifier
1972504926
Registry record updated Feb 20, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
NA Issued in NC
Legal business name
NORTH CAROLINA EYE EAR NOSE & THROAT PA
Practice address
4102 N Roxboro St
Durham, NC 27704-2122
Phone
(919) 595-2000
Fax
(919) 595-2186
NPI assigned
Aug 2, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2013

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

Authorized official

Name
Melissa B Myers
Title
Patient Accounting Manger
Phone
(919) 595-2106

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207W00000X NA NC Primary
Otolaryngology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Y00000X NA NC

Addresses

Primary practice location

4102 N Roxboro St
Durham, NC 27704-2122

Mailing address

4102 N Roxboro St
Durham, NC 27704-2122
Phone (919) 595-2000

Other identifiers 4

IdentifierTypeStateIssuer
8901750MedicaidNC
890248AMedicaidNC
01750OtherNCBCBCNC-OPHTHALMOLOGY
0248AOtherNCBCBSNC-OTOLARYNGOLOGY

National Provider Directory

National Provider Directory

Locations

1110 SE Cary Pkwy
Ste 100
Cary, NC 27518
Phone (919) 781-1050

5726 Fayetteville Rd
Ste 102
Durham, NC 27713
Phone (919) 682-9341

8300 Health Park
Ste 229
Raleigh, NC 27615
Phone (919) 510-5130

Practitioners & affiliated clinicians

Practitioners 30

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

View all 30

NPI Registry JSON

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

{
    "created_epoch": "1122940800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1361318400000",
    "number": "1972504926",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4102 N ROXBORO ST",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277042122",
            "telephone_number": "919-595-2000",
            "fax_number": "919-595-2186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4102 N ROXBORO ST",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277042122",
            "telephone_number": "919-595-2000",
            "fax_number": "919-595-2186"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH CAROLINA EYE EAR NOSE & THROAT PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-02",
        "last_updated": "2013-02-20",
        "status": "A",
        "authorized_official_last_name": "MYERS",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "PATIENT ACCOUNTING MANGER",
        "authorized_official_telephone_number": "919-595-2106"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Ophthalmology",
            "state": "NC",
            "license": "NA",
            "primary": true
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Otolaryngology",
            "state": "NC",
            "license": "NA",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8901750",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "890248A",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBCNC-OPHTHALMOLOGY",
            "identifier": "01750",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSNC-OTOLARYNGOLOGY",
            "identifier": "0248A",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Durham, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.