Active NPI
John Walter Story, M.D.
- Ophthalmology Physician
- Lancaster, SC
National Provider Identifier
1104823384
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ophthalmology Physician
- License
- 10512
- Practice address
- 209 S Wylie St
Lancaster, SC 29720-2353 - Phone
- (803) 285-7400
- Fax
- (803) 285-7554
- NPI assigned
- Jul 4, 2005
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Ophthalmology Physician | 207W00000X | 10512 | SC | Primary |
Addresses
Primary practice location
209 S Wylie St
Lancaster, SC 29720-2353
Mailing address
209 S Wylie St
Lancaster, SC 29720-2353
Phone (803) 285-7400
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| GP1986 | Medicaid | SC |
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)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1120435200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1328745600000",
"number": "1104823384",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "209 S WYLIE ST",
"city": "LANCASTER",
"state": "SC",
"postal_code": "297202353",
"telephone_number": "803-285-7400",
"fax_number": "803-285-7554"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "209 S WYLIE ST",
"city": "LANCASTER",
"state": "SC",
"postal_code": "297202353",
"telephone_number": "803-285-7400",
"fax_number": "803-285-7554"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STORY",
"first_name": "JOHN",
"middle_name": "WALTER",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-07-04",
"last_updated": "2012-02-09",
"status": "A"
},
"taxonomies": [
{
"code": "207W00000X",
"taxonomy_group": "",
"desc": "Ophthalmology",
"state": "SC",
"license": "10512",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "GP1986",
"state": "SC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lancaster, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.