NPIMap

Organization Active NPI

Tega Cay Eye Care, LLC

  • Optometrist
  • Tega Cay, SC
National Provider Identifier
1043482722
Registry record updated Feb 20, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1468 Issued in SC
Legal business name
TEGA CAY EYE CARE, LLC
Practice address
1151 Stonecrest Blvd
Tega Cay, SC 29708
Phone
(803) 802-4733
Fax
(803) 802-4735
NPI assigned
Apr 2, 2008
Last updated
Feb 20, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2013

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

Authorized official

Name
Larry F Jerge, ODNPI 1861492407
Title
Optometrist Owner
Phone
(803) 802-4733

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193200000X MULTI-SPECIALTY GROUP 152W00000X 1468 SC Primary

Addresses

Primary practice location

1151 Stonecrest Blvd
Tega Cay, SC 29708

Mailing address

600 Pine Links Dr
Tega Cay, SC 29704-7205
Phone (803) 802-4733

National Provider Directory

National Provider Directory

Locations

1151 Stonecrest Blvd
Tega Cay, SC 29708
Phone (803) 578-4120

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1207094400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1361318400000",
    "number": "1043482722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 PINE LINKS DR",
            "city": "TEGA CAY",
            "state": "SC",
            "postal_code": "297047205",
            "telephone_number": "803-802-4733",
            "fax_number": "803-802-4735"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1151 STONECREST BLVD",
            "city": "TEGA CAY",
            "state": "SC",
            "postal_code": "29708",
            "telephone_number": "803-802-4733",
            "fax_number": "803-802-4735"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TEGA CAY EYE CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-02",
        "last_updated": "2013-02-20",
        "status": "A",
        "authorized_official_last_name": "JERGE",
        "authorized_official_first_name": "LARRY",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "OPTOMETRIST OWNER",
        "authorized_official_telephone_number": "803-802-4733",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "SC",
            "license": "1468",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tega Cay, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.