Individual provider Active NPI

Carole M. Young, M.D.

  • Ophthalmology Physician
  • Georgetown, SC
National Provider Identifier
1033133772
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
13238 Issued in SC
Practice address
1200 Highmarket St
Suite 200
Georgetown, SC 29440-3227
Phone
(843) 546-8421
Fax
(843) 546-1173
NPI assigned
Jul 26, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 13238 SC Primary

Addresses

Primary practice location

1200 Highmarket St
Suite 200
Georgetown, SC 29440-3227

Mailing address

1200 Highmarket St
Suite 200
Georgetown, SC 29440-3227
Phone (843) 546-8421

Other identifiers 1

IdentifierTypeStateIssuer
132387MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110201000065 SC Practitioner - Ophthalmology 6002095445 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
13238SCMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Coastal Eye Group, P.C. Ophthalmology CurrentSince Jan 13, 1997 Accepting new patients
Coastal Eye Group, P.C. Ophthalmology CurrentSince Jan 13, 1997 Accepting new patients

Locations

1200 Highmarket St
Ste 200
Georgetown, SC 29440
Phone (803) 546-8421

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1033133772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 HIGHMARKET ST",
            "address_2": "SUITE 200",
            "city": "GEORGETOWN",
            "state": "SC",
            "postal_code": "294403227",
            "telephone_number": "843-546-8421",
            "fax_number": "843-546-1173"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 HIGHMARKET ST",
            "address_2": "SUITE 200",
            "city": "GEORGETOWN",
            "state": "SC",
            "postal_code": "294403227",
            "telephone_number": "843-546-8421",
            "fax_number": "843-546-1173"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "CAROLE",
        "middle_name": "M.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-26",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "SC",
            "license": "13238",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "132387",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Georgetown, SC

Sources for this page

Verify at the official NPI Registry.