James-Olivereyecare,LLC
Organization Active NPI Optometrist · York, SC
NPI 1033565643 · NPPES record last updated Jun 7, 2016
Key facts
- NPI
- 1033565643
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Optometrist 152W00000X
- License
- 1477 (SC)
- Legal business name
- JAMES-OLIVEREYECARE,LLC
- Practice address
- 46 N Congress St
York, SC 29745-1529 - Phone
- (803) 628-5477
- Fax
- (803) 628-5474
- NPI assigned
- May 12, 2016
- Organization subpart
- No
Authorized official
- Name
- Dr. Aleque Stegall James, OD
- Title
- Owner
- Phone
- (803) 628-5477
Practitioners 4
-
Aleque Stegall James, O.D.
-
David B Oliver, OD
-
William C Oliver, OD
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in SC
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20160620000378 | SC | Part B Supplier - Clinic/Group Practice | 5890086003 |
Receives reassigned benefits from 1 practitioner Practice locations: York, SC |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist |
152W00000X | 1477 | SC | Yes |
Addresses
Primary practice location
46 N Congress St
York, SC 29745-1529
Mailing address
46 N Congress St
York, SC 29745-1529
Phone (803) 628-5477
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| D14777 | Medicaid | SC |
Other providers in York, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 7, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.