Jason Siegmund, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

SC1389 Issued in SC

Practice address

540 Seaboard St
Myrtle Beach, SC 29577

Phone

(843) 626-6210

Fax

(843) 692-3094

NPI assigned

Dec 14, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in SC

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 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1166054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1420761600000",
    "number": "1073675690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8077 VERONA DR",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295728001",
            "telephone_number": "843-626-6210",
            "fax_number": "843-692-3094"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "540 SEABOARD ST",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "29577",
            "telephone_number": "843-626-6210",
            "fax_number": "843-692-3094"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIEGMUND",
        "first_name": "JASON",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-14",
        "last_updated": "2015-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "SC",
            "license": "SC1389",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SPECTERA",
            "identifier": "41155",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "D13894",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Teresa Jean Shumway, AU.D., CCC-A, FAAA
• Rima Siddiqui, M.D.
• Samia Joseph Sidrak, RPH
• Dena Siedenburg, RN
• Siegmund Eye Care PA
• Kelle Siegmund, OD
• Samuel Sifferlin, DPT
• Richard L. Sigmon Jr., MD
• Alec Sikarin, MD
• Silver Standard Speech Therapy LLC

• Optometrist in Myrtle Beach, SC
• Providers in Myrtle Beach, SC by specialty
• Optometrist in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.