Thomas R Miller Jr., OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

1802 Issued in NC

Practice address

11724 Retail Dr.
Wake Forest, NC 27587

Phone

(919) 562-5559

Fax

(919) 562-5563

NPI assigned

Oct 19, 2006

Last updated

Nov 17, 2023By the provider in NPPES

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 4

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

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Wake Forest Optometry PA

  dba Eye Care Center

  • Optometrist
  • Wake Forest, NC
  • NPI 1518139369
  Medicare reassignment NPD
• Northside Family Eye Care Optometry, PA

  • Optometrist
  • Fayetteville, NC
  • NPI 1730804337
  NPD
• The Eye Center, Doctors of Optometry, P.a.

  • Optometrist
  • Durham, NC
  • NPI 1174564900
  NPD (past)

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

{
    "created_epoch": "1161216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700179200000",
    "number": "1982786216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11724 RETAIL DR.",
            "city": "WAKE FOREST",
            "state": "NC",
            "postal_code": "27587",
            "telephone_number": "919-562-5559",
            "fax_number": "919-562-5563"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11724 RETAIL DR.",
            "city": "WAKE FOREST",
            "state": "NC",
            "postal_code": "27587",
            "telephone_number": "919-562-5559",
            "fax_number": "919-562-5563"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "THOMAS",
        "middle_name": "R",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-19",
        "last_updated": "2023-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NC",
            "license": "1802",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NC HEALTHCHOICE",
            "identifier": "0929Y",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "0929Y",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "890929Y",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTH CARE",
            "identifier": "2238815",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michelle Dattada, LCSW, PLLC
• Sola E Miles, M.H.S, PA-C
• Milestones Counseling, PLLC
• Adrian Miller
• Madalyn Miller
• Alyssa Michelle Mills, M.ED., LPCA, NCC
• Ashley Mills, MS, LCMHCA
• Brittany Dawn Mims, PA-C
• Mind & Mane
• Mind & Mane LLC

• Optometrist in Wake Forest, NC
• Providers in Wake Forest, 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 17, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.