Individual provider Active NPI

Michelle West Nagro, OD

  • Optometrist
  • Georgetown, SC
National Provider Identifier
1104497981
Registry record updated Jul 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2284 Issued in SC
Practice address
302 Church St
Georgetown, SC 29440-2406
Phone
(843) 546-2244
NPI assigned
Jul 2, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2284 SC Primary

Addresses

Primary practice location

302 Church St
Georgetown, SC 29440-2406

Mailing address

221 Bragdon Ave
Georgetown, SC 29440-6549
Phone (843) 240-7505

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mnagro@indigovisioncenter.net

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
I20210818003739 SC Practitioner - Optometry 6800291535 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 2021
Medicare assignment
May accept Medicare assignment
Group practices
Indigo Vision Center PAGroup PAC ID 0244280501, 3 clinicians

Practice addresses (Care Compare)

302 Church St
Georgetown, SC 29440-2406
Phone (843) 546-2244

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery41

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2284SCMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Indigo Vision Center PA Optometrist CurrentSince Aug 11, 2021 Accepting new patients

Locations

302 Church St
Georgetown, SC 29440
Phone (843) 546-2244

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1625184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625184000000",
    "number": "1104497981",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "221 BRAGDON AVE",
            "city": "GEORGETOWN",
            "state": "SC",
            "postal_code": "294406549",
            "telephone_number": "843-240-7505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "302 CHURCH ST",
            "city": "GEORGETOWN",
            "state": "SC",
            "postal_code": "294402406",
            "telephone_number": "843-546-2244"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAGRO",
        "first_name": "MICHELLE",
        "middle_name": "WEST",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-02",
        "last_updated": "2021-07-02",
        "certification_date": "2021-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "SC",
            "license": "2284",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mnagro@indigovisioncenter.net",
            "affiliation": "N",
            "endpointDescription": "Office email address",
            "address_1": "302 Church St",
            "city": "Georgetown",
            "state": "SC",
            "country_code": "US",
            "postal_code": "294402406",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Georgetown, SC

Sources for this page

Verify at the official NPI Registry.