Doctors Vision Center OD PA

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

DOCTORS VISION CENTER OD PA

Practice address

413 Mill St
Rocky Mount, NC 27804-4837

Phone

(252) 985-1371

Fax

(252) 985-2303

NPI assigned

May 2, 2006

Organization subpart

No

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

Authorized official

Name

Tina M Burgess

Title

Credentialing Specialist

Phone

(252) 985-1371

Specialties & licenses 2

Addresses

Other identifiers 3

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

{
    "created_epoch": "1146528000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213833600000",
    "number": "1972561660",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7396",
            "city": "ROCKY MOUNT",
            "state": "NC",
            "postal_code": "278040396",
            "telephone_number": "252-985-1371",
            "fax_number": "252-985-2303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "413 MILL ST",
            "city": "ROCKY MOUNT",
            "state": "NC",
            "postal_code": "278044837",
            "telephone_number": "252-985-1371",
            "fax_number": "252-985-2303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DOCTORS VISION CENTER OD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-02",
        "last_updated": "2008-06-19",
        "status": "A",
        "authorized_official_last_name": "BURGESS",
        "authorized_official_first_name": "TINA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "252-985-1371"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF NC  GROUP NUMBER",
            "identifier": "019E5",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5906240",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE GROUP",
            "identifier": "CJ5982",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2008; 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.