FAIRMONT EYE CLINIC OD PLLC
NPI 1871468413
Optometrist in Fairmont, NC
About Fairmont Eye Clinic Od Pllc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
FAIRMONT EYE CLINIC OD PLLC (NPI 1871468413) is a healthcare organization registered as an optometrist in Fairmont, North Carolina and active in the NPI registry since October 2025. The organization lists Samuel David Johnson, Owner/ Optometrist, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Fairmont Eye Clinic Od Pllc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
3Medicare enrollment records show 3 clinicians reassign Medicare billing to Fairmont Eye Clinic Od PLLC, which bills Medicare for the services they deliver. Of these, 3 practice at this address. They are listed nearest first.
Clinicians, nearest first (3)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 Fairmont Eye Clinic Od PLLC's NPI number?
The NPI number for Fairmont Eye Clinic Od PLLC is 1871468413. It was assigned to this organization in the NPPES registry on October 6, 2025.
Where is Fairmont Eye Clinic Od PLLC located?
Fairmont Eye Clinic Od PLLC is located at 204 Iona St, Fairmont, NC 28340. The listed phone number is (910) 628-8316.
What is Fairmont Eye Clinic Od PLLC's specialty?
The primary specialty registered for this NPI is Optometrist with taxonomy code 152W00000X.
Is Fairmont Eye Clinic Od PLLC enrolled in Medicare?
Yes. Fairmont Eye Clinic Od PLLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Fairmont Eye Clinic Od PLLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 3 clinicians, all in Optometry, reassign their Medicare billing to Fairmont Eye Clinic Od PLLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 3 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
When was this NPI record last updated?
The NPPES record for Fairmont Eye Clinic Od PLLC was last updated on October 6, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 months 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.
# Fairmont Eye Clinic Od Pllc · NPI 1871468413
Optometrist organization in Fairmont, North Carolina. Organization record, active in the CMS NPPES registry since October 6, 2025.
## Identity
- **NPI:** 1871468413 (Entity type: Organization)
- **Enumerated:** October 6, 2025
- **Primary specialty:** Optometrist · taxonomy 152W00000X
- **Organization subpart:** No
- **Authorized official:** Samuel Johnson, OWNER/ OPTOMETRIST
## Practice location
- **Address:** 204 IONA ST, Fairmont, NC 28340-1616
- **Phone:** (910) 628-8316 · **Fax:** (910) 628-5642
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 3 clinicians (Optometry) reassign Medicare billing to this organization (form CMS-855R); 3 practice at this address · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** October 6, 2025
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Source: [NPI Profile](https://npiprofile.com/npi/1871468413) · Data from the CMS NPPES public registry.