TRIAD OCULAR AND FACIAL PLASTIC SURGERY PLLC
NPI 1245737568
Ophthalmology - Ophthalmic Plastic and Reconstructive Surgery in Bermuda Run, NC
NPI Status: Active since April 12, 2018
Contact Information
122 E KINDERTON WAY # B
BERMUDA RUN, NC
ZIP 27006
Phone: (336) 448-3060
Fax: (336) 998-3333
- Organization
- Ophthalmology
- Ophthalmic Plastic and Reconstructive Su...
- Accepts Insurance
- CLIA Number: 34D2299956
- CLIA Cert. Type: Other - OFFIC BASED SURGERY CENTE
- CLIA Exp. Date: 02-28-2028
About TRIAD OCULAR AND FACIAL PLASTIC SURGERY PLLC
This page provides the complete NPI Profile along with additional information for Triad Ocular And Facial Plastic Surgery Pllc, a provider established in Bermuda Run, North Carolina operating as a Ophthalmology, focusing in ophthalmic plastic and reconstructive surgery . The healthcare provider is registered in the NPI registry with number 1245737568 assigned on April 2018. The practitioner's primary taxonomy code is 207WX0200X with license number 2015-01115 (NC). The provider is registered as an organization and their NPI record was last updated 7 years ago. Triad Ocular And Facial Plastic Surgery Pllc operates as a Multi-Specialty Group with one or more individual practitioners, who practice different areas of specialization. The authorized official of this NPI record is Molly Lynn Fuller Md, Phd (Owner)
- NPI
- 1245737568
- Provider Name
- TRIAD OCULAR AND FACIAL PLASTIC SURGERY PLLC
- Entity Type
- Organization
- Location Address
- 122 E KINDERTON WAY # B BERMUDA RUN, NC 27006
- Location Phone
- (336) 448-3060
- Location Fax
- (336) 998-3333
- Mailing Address
- 5335 ROBINHOOD VILLAGE DR # 178 WINSTON SALEM, NC 27106
- Mailing Phone
- (336) 448-3060
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 04-12-2018
- Last Update Date
- 04-05-2019
- Code Navigator
Location Map
Secondary Locations
- 225 East Lee Avenue
Yadkinville, NC 27055
(336) 448-3060 - 2 Hospital Dr
Lexington, NC 27292
(336) 448-3060
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Ophthalmology Ophthalmic Plastic and Reconstructive Surgery
- Taxonomy Code
- 207WX0200X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- 2015-01115
- License State
- NC
- Taxonomy Description
- A physician who specializes in oculofacial plastic and reconstructive surgery. This subspecialty combines orbital and periocular surgery with facial plastic surgery, and includes aesthetic and reconstructive surgery of the face, orbit, eyelid, and lacrimal system. Practitioners evaluate, diagnose and treat conditions involving the eyelids, brows, midface, orbits, lacrimal systems and surrounding and supporting structures of the face and neck.
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 2082S0099X | Allopathic & Osteopathic Physicians | Plastic Surgery | 2015-01115 (NC) |
Group Taxonomy 193200000X MULTI-SPECIALTY GROUP
This provider is a business group of one or more individual practitioners, who practice with different areas of specialization.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Blue Advantage Bronze Basic | 3 Free PCP | $25 Tier 1 Rx | Integrated | Nationwide Doctors - PPO
- Blue Advantage Bronze Complete | $60 PCP | $20 Tier 1 Rx | Nationwide Doctors - PPO
- Blue Advantage Bronze HSA Eligible | Integrated | Nationwide Doctors - PPO
- Blue Advantage Bronze Standard | Nationwide Doctors - PPO
- Blue Advantage Gold Premier A | 3 Free PCP | $10 Tier 1 Rx | Nationwide Doctors - PPO
- Blue Advantage Gold Standard A | Nationwide Doctors - PPO
- Blue Advantage Silver Choice A | 3 Free PCP | $15 Tier 1 Rx | Nationwide Doctors - PPO
- Blue Advantage Silver Preferred | 3 Free PCP | $10 Tier 1 Rx | Integrated | Nationwide Doctors - PPO
- Blue Advantage Silver Standard | Nationwide Doctors - PPO
- Blue Care Bronze Basic | 3 Free PCP | $25 Tier 1 Rx | Integrated | Statewide Doctors - HMO
- Blue Care Bronze Complete | $60 PCP | $20 Tier 1 Rx | Statewide Doctors - HMO
- Blue Care Bronze HSA Eligible | Integrated | Statewide Doctors - HMO
- Blue Care Bronze Standard | Statewide Doctors - HMO
- Blue Care Gold Premier A | 3 Free PCP | $10 Tier 1 Rx | Statewide Doctors - HMO
- Blue Care Gold Standard A | Statewide Doctors - HMO
- Blue Care Silver Choice A | 3 Free PCP | $15 Tier 1 Rx | Statewide Doctors - HMO
- Blue Care Silver Preferred | 3 Free PCP | $10 Tier 1 Rx | Integrated | Statewide Doctors - HMO
- Blue Care Silver Standard | Statewide Doctors - HMO
- Blue Local Bronze Basic | 3 Free PCP | $25 Tier 1 Rx | Integrated | with Atrium Health - EPO
- Blue Local Bronze Complete | $60 PCP | $20 Tier 1 Rx | with Atrium Health - EPO
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 34D2299956
- Facility Type
- Other - OFFIC BASED SURGERY CENTE
- Certificate Effective Date
- February 28, 2026
- Certificate Expiration Date
- February 28, 2028
- Laboratory Director
- MOLLY L. FULLER
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Triad Ocular And Facial Plastic Surgery Pllc to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1245737568, we treat the final digit (8) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 62. The final step is to find the difference between that total and the next multiple of ten (70 - 62 = 8).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 62 is 70. The difference is the calculated check digit.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1245737568, enumerated as an "organization" on April 12, 2018.
The provider is located at 122 E KINDERTON WAY # B BERMUDA RUN, NC 27006 and the phone number is (336) 448-3060.
Ophthalmology with taxonomy code 207WX0200X and a focus in Ophthalmic Plastic and Reconstructive Surgery.
The provider might be accepting Accepts: Blue Cross and Blue Shield of NC. Please consult your insurance carrier or call the provider to verify.
