Organization Active NPI

Ivision Associates LLC

  • Optometrist
  • Indian Land, SC
National Provider Identifier
1093227464
Registry record updated Apr 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
IVISION ASSOCIATES LLC
Practice address
9700 Red Stone Drive Suite 300
Indian Land, SC 29707
Phone
(224) 848-9385
NPI assigned
Oct 25, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2021

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

Authorized official

Name
Bhumika Patel, ODNPI 1194134668
Title
Optometrist
Phone
(224) 848-9385

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: 193400000X SINGLE SPECIALTY GROUP 152W00000X Primary

Addresses

Primary practice location

9700 Red Stone Drive Suite 300
Indian Land, SC 29707

Mailing address

9700 Redstone Dr Ste 300
Indian Land, SC 29707-5409
Phone (803) 548-3937

Other identifiers 1

IdentifierTypeStateIssuer
DA9497MedicaidSC

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190318000032 SC Part B Supplier - Clinic/Group Practice 7911247655 Receives reassigned benefits from 2 practitioners
Practice locations: Indian Land, SC

National Provider Directory

National Provider Directory
Tax ID family
Ivision Associates2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1508889600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1619654400000",
    "number": "1093227464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9700 REDSTONE DR STE 300",
            "city": "INDIAN LAND",
            "state": "SC",
            "postal_code": "297075409",
            "telephone_number": "803-548-3937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9700 RED STONE DRIVE SUITE 300",
            "city": "INDIAN LAND",
            "state": "SC",
            "postal_code": "29707",
            "telephone_number": "224-848-9385"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IVISION ASSOCIATES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-10-25",
        "last_updated": "2021-04-29",
        "certification_date": "2021-04-29",
        "status": "A",
        "authorized_official_last_name": "PATEL",
        "authorized_official_first_name": "BHUMIKA",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "224-848-9385",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "DA9497",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Indian Land, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2021; 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.