Individual provider Active NPI

Jennifer Joyce Camp, O.D.

  • Optometrist
  • Blythewood, SC
National Provider Identifier
1083604664
Registry record updated May 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1921 Issued in SC
Practice address
204 Langford Rd
Blythewood, SC 29016-8648
Phone
(803) 714-1116
Fax
(803) 714-1162
NPI assigned
Oct 25, 2005
Last updated
May 15, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 15, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 6163T TX
Optometrist 152W00000X 1921 SC Primary

Addresses

Primary practice location

204 Langford Rd
Blythewood, SC 29016-8648

Mailing address

248 Lake Carolina Blvd
Columbia, SC 29229-7539
Phone (210) 663-1443

Other practice location 1

1718 Saint Julian Pl
Columbia, SC 29204-2410
Phone (803) 708-8392

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20181109001981 SC Practitioner - Optometry 8022362037 Reassigns benefits to 3 organizations
Practice locations: Columbia, SC

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern California College of Optometry, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dr Sara Beaver LLCGroup PAC ID 3577833706, 3 clinicians

Practice addresses (Care Compare)

204 Langford Rd
Blythewood, SC 29016-8648
Phone (803) 714-1116

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6163TTXMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
360Care LLC Optometrist CurrentSince Feb 3, 2020 Accepting new patients
360Care LLC CurrentSince Feb 3, 2020 Accepting new patients
Mobile Vision of South Carolina, LLC Optometrist CurrentSince Nov 15, 2018 Accepting new patients
Dr. Sara Beaver, LLC Optometrist CurrentSince Feb 3, 2021 Accepting new patients

Locations

12910 Shelbyville Rd
Ste 300
Louisville, KY 40243
Phone (502) 214-0693

4350 Brownsboro Rd
Ste 200
Louisville, KY 40207
Phone (513) 771-7483

204 Langford Rd
Blythewood, SC 29016
Phone (803) 714-1116

1703 Laurel St
Columbia, SC 29201
Phone 24852821166

717 Trolley Rd
Summerville, SC 29485

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1130198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778803200000",
    "number": "1083604664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "248 LAKE CAROLINA BLVD",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292297539",
            "telephone_number": "210-663-1443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "204 LANGFORD RD",
            "city": "BLYTHEWOOD",
            "state": "SC",
            "postal_code": "290168648",
            "telephone_number": "803-714-1116",
            "fax_number": "803-714-1162"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1718 Saint Julian Pl",
            "address_purpose": "LOCATION",
            "city": "Columbia",
            "state": "SC",
            "postal_code": "292042410",
            "country_code": "US",
            "telephone_number": "803-708-8392",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CAMP",
        "first_name": "JENNIFER",
        "middle_name": "JOYCE",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-10-25",
        "last_updated": "2026-05-15",
        "certification_date": "2026-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "6163T",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "SC",
            "license": "1921",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Blythewood, SC

Sources for this page

Verify at the official NPI Registry.