Individual provider Active NPI

Ashlee Finnell, OD

  • Optometrist
  • Manning, SC
National Provider Identifier
1053806372
Registry record updated Jun 28, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2078 Issued in SC
Practice address
1774 Paxville Hwy
Manning, SC 29102-5071
Phone
(803) 435-8765
NPI assigned
Jun 28, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2078 SC Primary

Addresses

Primary practice location

1774 Paxville Hwy
Manning, SC 29102-5071

Mailing address

1774 Paxville Hwy
Manning, SC 29102-5071
Phone (803) 435-8765

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC, WI2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20180823002722 SC Practitioner - Optometry 3476802414 Reassigns benefits to 1 organization
I20191029000364 WI Practitioner - Optometry 3476802414 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pennsylvania State University College of Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lake Country Eye Care LLCGroup PAC ID 1254654742, 5 clinicians

Practice addresses (Care Compare)

520 Hartbrook Dr
F
Hartland, WI 53029-1405
Phone (262) 367-6610

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2078SCMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Lake Country Eye Care, LLC Optometrist CurrentSince Mar 25, 2024 Accepting new patients
Myeyedr Optometry of South Carolina, LLC Optometrist CurrentSince Jul 2, 2018 Accepting new patients
Myeyedr Optometry South Carolina, LLC Optometrist CurrentSince Jul 2, 2018 Accepting new patients
Myeyedr Optometry of South Carolina, LLC Optometrist Current Accepting new patients

Locations

1774 Paxville Hwy
Manning, SC 29102
Phone (803) 435-2494

1268 Ebenezer Rd
Rock Hill, SC 29732
Phone (803) 327-2001

8614 Westwood Center Dr
Fl 9
Vienna, VA 22182

1950 Old Gallows Rd
Ste 520
Vienna, VA 22182

520 Hartbrook Dr
#F
Hartland, WI 53029
Phone (262) 367-6610

520 Hartbrook Dr
Ste F
Hartland, WI 53029
Phone (262) 367-6610

N63W23524 Silver Spring Dr
Sussex, WI 53089
Phone (262) 246-6486

Organizations & group practices 4

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": "1530144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530144000000",
    "number": "1053806372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1774 PAXVILLE HWY",
            "city": "MANNING",
            "state": "SC",
            "postal_code": "291025071",
            "telephone_number": "803-435-8765"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1774 PAXVILLE HWY",
            "city": "MANNING",
            "state": "SC",
            "postal_code": "291025071",
            "telephone_number": "803-435-8765"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FINNELL",
        "first_name": "ASHLEE",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-28",
        "last_updated": "2018-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "SC",
            "license": "2078",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manning, SC

Sources for this page

Verify at the official NPI Registry.