Healthcare Provider Details

I. General information

NPI: 1316854748
Provider Name (Legal Business Name): LEGACY EYE CARE OF NORTH CAROLINA OD, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/24/2026
Last Update Date: 08/24/2026
Certification Date: 08/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2603 HOLLY HILL ST
BURLINGTON NC
27215-5156
US

IV. Provider business mailing address

1054 CARDROSS ST
BURLINGTON NC
27215-8566
US

V. Phone/Fax

Practice location:
  • Phone: 336-228-6423
  • Fax: 336-228-6432
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State

VIII. Authorized Official

Name: JENNA RONEY
Title or Position: OWNER/OPTOMETRIST
Credential: OD
Phone: 336-437-2544