Organization Active NPI

Jones Family Eyecare, PC

  • Optometrist
  • Hartsville, SC
National Provider Identifier
1033162946
Registry record updated Jan 8, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1243 Issued in SC
Legal business name
JONES FAMILY EYECARE, PC
Practice address
122 S 4TH St
Hartsville, SC 29550-4220
Phone
(843) 332-8323
NPI assigned
May 19, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2008

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

Authorized official

Name
Dr. Keith Alan Jones, O.D.NPI 1942258900
Title
Owner
Phone
(843) 332-8323

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 1243 SC Primary

Addresses

Primary practice location

122 S 4TH St
Hartsville, SC 29550-4220

Mailing address

122 S 4TH St
Hartsville, SC 29550-4220
Phone (843) 332-8323

Other identifiers 1

IdentifierTypeStateIssuer
DA9730MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040831001115 SC Part B Supplier - Clinic/Group Practice 3476528662 Receives reassigned benefits from 2 practitioners
Practice locations: Hartsville, SC

National Provider Directory

National Provider Directory

Locations

200 Darlington Ave
Hartsville, SC 29550
Phone (843) 332-1009

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1147996800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1199750400000",
    "number": "1033162946",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "122 S 4TH ST",
            "city": "HARTSVILLE",
            "state": "SC",
            "postal_code": "295504220",
            "telephone_number": "843-332-8323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "122 S 4TH ST",
            "city": "HARTSVILLE",
            "state": "SC",
            "postal_code": "295504220",
            "telephone_number": "843-332-8323"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JONES FAMILY EYECARE, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-19",
        "last_updated": "2008-01-08",
        "status": "A",
        "authorized_official_last_name": "JONES",
        "authorized_official_first_name": "KEITH",
        "authorized_official_middle_name": "ALAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "843-332-8323",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "SC",
            "license": "1243",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "DA9730",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hartsville, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.