Active NPI
Jah'Rena Williams, ABO, LDO
- Optician
- Columbia, SC
National Provider Identifier
1104635416
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optician
- License
- 1460
- Practice address
- 10060 Two Notch Rd
Columbia, SC 29223-4396 - Phone
- (803) 419-6240
- Fax
- (803) 419-6742
- NPI assigned
- Jan 1, 2025
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optician | 156FX1800X | 1460 | SC | Primary |
Addresses
Primary practice location
10060 Two Notch Rd
Columbia, SC 29223-4396
Mailing address
200 N Beltline Dr
Florence, SC 29501-7403
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Bachelor of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1460 | SC | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1735689600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1787961600000",
"number": "1104635416",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "200 N BELTLINE DR",
"city": "FLORENCE",
"state": "SC",
"postal_code": "295017403"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10060 TWO NOTCH RD",
"city": "COLUMBIA",
"state": "SC",
"postal_code": "292234396",
"telephone_number": "803-419-6240",
"fax_number": "803-419-6742"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILLIAMS",
"first_name": "JAH'RENA",
"credential": "ABO, LDO",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-01-01",
"last_updated": "2026-08-29",
"certification_date": "2026-08-29",
"status": "A"
},
"taxonomies": [
{
"code": "156FX1800X",
"taxonomy_group": "",
"desc": "Technician/Technologist, Optician",
"state": "SC",
"license": "1460",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Columbia, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.