EYECARECENTER OD PA (NPI# 1003861212) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003861212 |
| Entity Type | Organization |
| Organization Name | EYECARECENTER OD PA |
| Practice Address |
4130 Western Blvd Jacksonville NC 28546-6740 |
| Mailing Address |
Po Box 207261 Dallas TX 75320-7261 |
| Practice Telephone | 6362004393 |
| Practice Fax Number | 9103535459 |
| Mailing Telephone | 6362004393 |
| Mailing Fax Number | 6365270766 |
| Enumeration Date | 2006-05-24 |
| Last Update Date | 2019-06-20 |
| Authorized Official Name | DR. KENNETH ALLAN GREGG (PRESIDENT) |
| Authorized Official Telephone | 2524515324 |
| Authorized Official Credential | OD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 152W00000X | Optometrist | Eye and Vision Services Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | BCBSNC GROUP NUMBER | 0912F | 01 |
| NC | 890912F | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497388326 | Eyecarecenter Od Pa | Optometrist | 128 N Park St, Asheboro, NC 27203-5440 | 2020-02-19 |
| 1649759341 | Eyecarecenter Od Pa | Optometrist | 275 E King St Ste A, Boone, NC 28607-5504 | 2018-08-13 |
| 1669905634 | Eyecarecenter Od Pa | Optometrist | 119 E Hargett St, Raleigh, NC 27601-1579 | 2017-04-06 |
| 1346781721 | Eyecarecenter Od Pa | Optometrist | 1575 Nc Highway 66 S, Kernersville, NC 27284-3516 | 2017-03-17 |
| 1184165607 | Eyecarecenter Od Pa | Optometrist | 5121 Reidsville Rd, Walkertown, NC 27051-9770 | 2017-03-16 |
| 1154739563 | Eyecarecenter Od Pa | Optometrist | 190 Independance Ave, Suite A, North Wilkesboro, NC 28659-4217 | 2014-07-29 |
| 1033371414 | Eyecarecenter Od Pa | Optometrist | 1127 Military Cutoff Rd Ste C, Wilmington, NC 28405-3682 | 2008-06-27 |
| 1376582239 | Eyecarecenter Od Pa | Optometrist | 3001 Raleigh Road Pkwy W, Wilson, NC 27896-8213 | 2006-06-06 |
| 1932152964 | Eyecarecenter Od Pa | Optometrist | 1007a Skyway Dr, Monroe, NC 28110-3042 | 2006-05-19 |
| 1902859952 | Eyecarecenter Od Pa | Optometrist | 1813 W Ehringhaus St, Elizabeth City, NC 27909-4555 | 2006-05-19 |
| Street Address |
4130 WESTERN BLVD |
| City | JACKSONVILLE |
| State | NC |
| Zip Code | 28546-6740 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457597676 | Carrie Renee Turley | Optometrist | 4130 Western Blvd, Jacksonville, NC 28546-6740 | 2008-12-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316578388 | Judylyn Hobson | Registered Nurse | Pride In North Carolina, LLC, 3886 Henderson Dr, Jacksonville, NC 28546 | 2020-01-29 |
| 1427694637 | Aaron Patrick Bettcher | Military Health Care Provider | 3rd Mrb Loop Rd, Camp Lejeune, NC 28546 | 2019-11-22 |
| 1962044289 | Levi Scott Marshall | Military Health Care Provider | Everett Creek Road, Building 612, Camp Lejeune, NC 28546 | 2019-10-09 |
| 1649826652 | Nicholas Otazo | Military Health Care Provider | 3rd Mrb 20073, Camp Lejeune, NC 28546 | 2019-08-15 |
| 1417519570 | Publix North Carolina, Lp | Durable Medical Equipment & Medical Supplies | 2001 Marlin Drive Unit 100, Jacksonville, NC 28546 | 2019-06-28 |
| 1023500212 | Josip Ninrodriguez | Military Health Care Provider | 3d Marine Raider Battaliom, Camp Lejeune, NC 28546 | 2018-06-04 |
| 1639661192 | Kenneth Lee Russell | Military Health Care Provider | 3d Marine Raider Battalion, Camp Lejeune, NC 28546 | 2018-05-31 |
| 1346730173 | Coastal Foot Center, LLC | Clinic/Center | 29 Office Park Dr Ste B, Jacksonville, NC 28546 | 2018-05-17 |
| 1578080271 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 380 Western Blvd, Jacksonville, NC 28546 | 2017-08-24 |
| 1144757493 | Darin Lee Peterson | Specialist/Technologist | G644 Camp Geiger, School of Infantry-east, Jacksonville, NC 28546 | 2017-05-17 |
| Find all providers in zip 28546 | ||||
| Taxonomy Code | 152W00000X |
| Grouping | Eye and Vision Services Providers |
| Classification | Optometrist |
| Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system. |
| Notes: Source: American Optometric Association (AOA), approved by the AOA’s Board of Trustees, June 21, 2005. [7/1/2006: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215553367 | Myeyedr Optometry of Florida, LLC | Optometrist | 2152 3rd St S # 60, Jacksonville, FL 32250-4019 | 2020-06-24 |
| 1154945814 | Kaitlin Jaquett Brown | Optometrist | 4788 Hodges Blvd Ste 205, Jacksonville, FL 32224-7223 | 2020-05-29 |
| 1831745660 | National Vision Inc | Optometrist | 14021 Lunar Drive, Unit 1, Jacksonville, FL 32218-7290 | 2019-08-16 |
| 1144876475 | Myeyedr Optometry of Florida, LLC | Optometrist | 11945 San Jose Blvd Ste 202, Jacksonville, FL 32223-1612 | 2019-08-13 |
| 1295294742 | Myeyedr Optometry of Florida, LLC | Optometrist | 13760 Old Saint Augustine Rd Ste 102, Jacksonville, FL 32258-5492 | 2019-03-14 |
| 1922578558 | Fatima Hussain Crofton | Optometrist | 7051 Southpoint Parkway S 300, Jacksonville, FL 32216 | 2018-11-27 |
| 1356820211 | Nisha Patel | Optometrist | 10300 Southside Blvd Ste 114, Jacksonville, FL 32256-6759 | 2018-08-11 |
| 1538650155 | Vision Today Pllc | Optometrist | 9365-2 Atlantic Blvd, Jacksonville, FL 32225-8203 | 2018-05-21 |
| 1447765748 | Sudduth Vision Pllc | Optometrist | 8000 Parramore Rd., Jacksonville, FL 32244 | 2017-12-08 |
| 1851806657 | Ann Huynh Nguyen | Optometrist | 9041 Southside Blvd Ste 174, Jacksonville, FL 32256-8482 | 2017-12-04 |
| Find all providers in JACKSONVILLE | ||||
| City | JACKSONVILLE |
| Zip Code | 28546 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.