SUMMIT EYE CARE OF MOCKSVILLE PA
NPI 1417594656
Ophthalmology in Mocksville, NC

Q: What is Summit Eye Care Of Mocksville PA's NPI number?

The NPI number for Summit Eye Care Of Mocksville PA is 1417594656. It was assigned to this organization in the NPPES registry on December 6, 2019.

Q: What is Summit Eye Care Of Mocksville PA's specialty?

The primary specialty registered for this NPI is Ophthalmology with taxonomy code 207W00000X.

Active since December 06, 2019CLIA 34D2066213 · Waiver

1102C YADKINVILLE RD, MOCKSVILLE, NC 27028(336) 751-5734(336) 751-4968 Get Directions Write a Review

NPPES record last updated: March 21, 2023. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Mar 21, 2023, Mar 3, 2020, Dec 6, 2019 (3 updates tracked since 2019).

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About Summit Eye Care Of Mocksville Pa NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SUMMIT EYE CARE OF MOCKSVILLE PA (NPI 1417594656) is a healthcare organization registered as an ophthalmology in Mocksville, North Carolina and active in the NPI registry since December 2019. The organization holds a CLIA Waiver certificate valid through September 23, 2027 and lists Vickas Khemsara, Owner, as its authorized official.

NPPES Registry Identity

NPI1417594656

Entity TypeOrganization

Primary Taxonomy207W00000X

Legal Business NameSUMMIT EYE CARE OF MOCKSVILLE PA

Location Address1102C YADKINVILLE RDMocksville, NC 27028-2037

Mailing Address1102c Yadkinville RdMocksville, NC 27028-2037 · (336) 751-5734

Phone(336) 751-5734

Fax(336) 751-4968

Organization SubpartNo

Authorized OfficialVickas KhemsaraOwner · (336) 765-0960

Enumeration DateDecember 6, 2019

Last NPPES UpdateMarch 21, 20233 updates tracked since enumeration

NPPES CertifiedMarch 21, 2023

✔ NPI 1417594656 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOphthalmologyAllopathic & Osteopathic Physicians

Taxonomy Code207W00000X

Definition

An ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses.

1102C YADKINVILLE RD, Mocksville, NC 27028

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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BlueCross BlueShield of Tennessee.Insurance ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 34D2066213

Summit Eye Care, PA · Winston-Salem, NC

Active · expires Sep 23, 2027

CLIA Number34D2066213

Laboratory TypePhysician Office

Certificate Effective DateSeptember 24, 2025

Certificate Expiration DateSeptember 23, 2027

Laboratory DirectorVic Khemsara

Laboratory Phone(336) 765-0960

Laboratory LocationSummit Eye Care, PA3073 Trenwest Drive, Winston-Salem, NC 27103

CLIA data matches this NPI record on: Name Phone

This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

THERESA ANN WATT

Optometrist

1102C YADKINVILLE RD
MOCKSVILLE, NC 27028

Davie County (336) 751-5734

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Summit Eye Care Of Mocksville PA's NPI number?

The NPI number for Summit Eye Care Of Mocksville PA is 1417594656. It was assigned to this organization in the NPPES registry on December 6, 2019.

Where is Summit Eye Care Of Mocksville PA located?

Summit Eye Care Of Mocksville PA is located at 1102C Yadkinville Rd, Mocksville, NC 27028. The listed phone number is (336) 751-5734.

What is Summit Eye Care Of Mocksville PA's specialty?

The primary specialty registered for this NPI is Ophthalmology with taxonomy code 207W00000X.

Does Summit Eye Care Of Mocksville PA hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 34D2066213) is associated with this NPI, valid through September 23, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Summit Eye Care Of Mocksville PA accept?

Health plans from BlueCross BlueShield of Tennessee list Summit Eye Care Of Mocksville PA as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Summit Eye Care Of Mocksville PA was last updated on March 21, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.