NPIMap

Organization Active NPI

Clark Optometric Center of SC, P.a.

  • Optometrist
  • Simpsonville, SC
National Provider Identifier
1063981900
Registry record updated Jan 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
CLARK OPTOMETRIC CENTER OF SC, P.A.
Practice address
419 SE Main St Ste 300
Simpsonville, SC 29681-2676
Phone
(864) 417-2345
Fax
(864) 399-4519
NPI assigned
Nov 21, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2026

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

Authorized official

Name
Mr. Anthony R Clark, ODNPI 1003862210
Title
Chief Medical Officer
Phone
(919) 544-4097

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: 193200000X MULTI-SPECIALTY GROUP 152W00000X Primary

Addresses

Primary practice location

419 SE Main St Ste 300
Simpsonville, SC 29681-2676

Mailing address

200 Perimeter Park Drive
Unit D
Morrisville, NC 27560
Phone (919) 544-4097

Other practice location 1

479 Bypass 72 NW Ste 107
Greenwood, SC 29649-1484
Phone (864) 388-9663

Other practice location 2

1014 W Poinsett St
Greer, SC 29650-1315
Phone (864) 877-4011

Other names 1

  • Triangle Visions Optometry Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190115001847 SC Part B Supplier - Clinic/Group Practice 0446596274 Receives reassigned benefits from 14 practitioners
Practice locations: Greenwood, SC; Simpsonville, SC; Greer, SC

National Provider Directory

National Provider Directory

Locations

200 Perimeter Park Dr
Ste D
Morrisville, NC 27560
Phone (910) 893-4141

479 Bypass 72 NW
Ste 107
Greenwood, SC 29649
Phone (864) 388-2020

479 Bypass 72 NW
Greenwood, SC 29649
Phone (864) 732-1542

1001 Main St S
Greenwood, SC 29646
Phone (864) 223-1960

Practitioners & affiliated clinicians

Practitioners 16

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

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1542758400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1768176000000",
    "number": "1063981900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 PERIMETER PARK DRIVE",
            "address_2": "UNIT D",
            "city": "MORRISVILLE",
            "state": "NC",
            "postal_code": "27560",
            "telephone_number": "919-544-4097",
            "fax_number": "919-678-3814"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "419 SE MAIN ST STE 300",
            "city": "SIMPSONVILLE",
            "state": "SC",
            "postal_code": "296812676",
            "telephone_number": "864-417-2345",
            "fax_number": "864-399-4519"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "479 Bypass 72 NW Ste 107",
            "address_purpose": "LOCATION",
            "city": "Greenwood",
            "state": "SC",
            "postal_code": "296491484",
            "country_code": "US",
            "telephone_number": "864-388-9663",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1014 W Poinsett St",
            "address_purpose": "LOCATION",
            "city": "Greer",
            "state": "SC",
            "postal_code": "296501315",
            "country_code": "US",
            "telephone_number": "864-877-4011",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "CLARK OPTOMETRIC CENTER OF SC, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-11-21",
        "last_updated": "2026-01-12",
        "certification_date": "2026-01-12",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "ANTHONY",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "CHIEF MEDICAL OFFICER",
        "authorized_official_telephone_number": "919-544-4097",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Triangle Visions Optometry",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Triangle Visions Optometry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Simpsonville, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2026; 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.