NPIMap

Organization Active NPI

Academy Eye Center Optometry, PA

  • Optometrist
  • Thomasville, NC
National Provider Identifier
1972724201
Registry record updated Sep 25, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1464 Issued in NC
Legal business name
ACADEMY EYE CENTER OPTOMETRY, PA
Practice address
1040 Randolph St
Suite 32
Thomasville, NC 27360-6383
Phone
(336) 475-0151
Fax
(336) 472-6831
NPI assigned
May 2, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2009

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

Authorized official

Name
Jennie Mitchell
Title
Office Administrator
Phone
(336) 905-9745

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 1464 NC Primary

Addresses

Primary practice location

1040 Randolph St
Suite 32
Thomasville, NC 27360-6383

Mailing address

213 W Naomi St
Randleman, NC 27317-1733
Phone (336) 495-3019

Other identifiers 3

IdentifierTypeStateIssuer
5901580MedicaidNC
0853510001OtherNCCIGNA GOVERNMENT SERVICES MEDICARE PART B DME
011KTOtherNCBCBS GROUP-T

National Provider Directory

National Provider Directory

Locations

213 W Naomi St
Randleman, NC 27317

Practitioners & affiliated clinicians

Practitioners 8

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": "1178064000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1253836800000",
    "number": "1972724201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "213 W NAOMI ST",
            "city": "RANDLEMAN",
            "state": "NC",
            "postal_code": "273171733",
            "telephone_number": "336-495-3019",
            "fax_number": "336-495-5703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1040 RANDOLPH ST",
            "address_2": "SUITE 32",
            "city": "THOMASVILLE",
            "state": "NC",
            "postal_code": "273606383",
            "telephone_number": "336-475-0151",
            "fax_number": "336-472-6831"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACADEMY EYE CENTER OPTOMETRY, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-02",
        "last_updated": "2009-09-25",
        "status": "A",
        "authorized_official_last_name": "MITCHELL",
        "authorized_official_first_name": "JENNIE",
        "authorized_official_title_or_position": "OFFICE ADMINISTRATOR",
        "authorized_official_telephone_number": "336-905-9745"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "NC",
            "license": "1464",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5901580",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA GOVERNMENT SERVICES MEDICARE PART B DME",
            "identifier": "0853510001",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS GROUP-T",
            "identifier": "011KT",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Thomasville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2009; 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.