Active NPI
Vicki W Chamberlain, OPTICIAN
- Ophthalmic Technician/Technologist
- Goose Creek, SC
National Provider Identifier
1063536142
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ophthalmic Technician/Technologist
- License
- 535
- Practice address
- 217 Saint James Ave
Ste. A5
Goose Creek, SC 29445-2938 - Phone
- (843) 797-5711
- Fax
- (843) 797-5712
- NPI assigned
- Mar 16, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ophthalmic Technician/Technologist | 156FX1100X | 535 | SC | Primary |
Addresses
Primary practice location
217 Saint James Ave
Ste. A5
Goose Creek, SC 29445-2938
Mailing address
217 St. James Avenue
Ste. A5
Goose Creek, SC 29445
Phone (843) 797-5711
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| DV5352 | Medicaid | SC |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 535 | SC | MD | Ophthalmic Technician/Technologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Eye Care Associates of SC LLC | Past | Accepting new patients | |
| 20/20 Vision Center Inc | Past | Accepting new patients |
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.
-
- Optician
- Goose Creek, SC
- NPI 1124048053
-
- Optometrist
- Chapin, SC
- NPI 1679046569
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174003200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1063536142",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "217 ST. JAMES AVENUE",
"address_2": "STE. A5",
"city": "GOOSE CREEK",
"state": "SC",
"postal_code": "29445",
"telephone_number": "843-797-5711",
"fax_number": "843-797-5712"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "217 SAINT JAMES AVE",
"address_2": "STE. A5",
"city": "GOOSE CREEK",
"state": "SC",
"postal_code": "294452938",
"telephone_number": "843-797-5711",
"fax_number": "843-797-5712"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHAMBERLAIN",
"first_name": "VICKI",
"middle_name": "W",
"name_prefix": "Mrs.",
"credential": "OPTICIAN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-16",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "156FX1100X",
"taxonomy_group": "",
"desc": "Technician/Technologist, Ophthalmic",
"state": "SC",
"license": "535",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "DV5352",
"state": "SC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Goose Creek, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.