Organization Active NPI

Carolina Eye and Ear Associates LLC

  • Otolaryngology Physician
  • Columbia, SC
National Provider Identifier
1114099553
Registry record updated Apr 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
0689474 Issued in SC
Legal business name
CAROLINA EYE AND EAR ASSOCIATES LLC
Practice address
2016 Sumter St
Columbia, SC 29201-2100
Phone
(803) 744-2700
Fax
(803) 744-7979
NPI assigned
Nov 14, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2008

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

Authorized official

Name
Maggie Agosto
Title
Business Manager
Phone
(803) 744-4103

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207W00000X 0689474 SC
Otolaryngology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Y00000X 0689474 SC Primary

Addresses

Primary practice location

2016 Sumter St
Columbia, SC 29201-2100

Mailing address

2016 Sumter St
Columbia, SC 29201-2100
Phone (803) 744-2700

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070102000094 SC Part B Supplier - Clinic/Group Practice 5294735031 Receives reassigned benefits from 4 practitioners
Practice locations: Columbia, SC

National Provider Directory

National Provider Directory

Locations

2016 Sumter St
Columbia, SC 29201
Phone (803) 744-2700

Practitioners & affiliated clinicians

Practitioners 4

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": "1163462400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208649600000",
    "number": "1114099553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2016 SUMTER ST",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292012100",
            "telephone_number": "803-744-2700",
            "fax_number": "803-744-7979"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2016 SUMTER ST",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292012100",
            "telephone_number": "803-744-2700",
            "fax_number": "803-744-7979"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAROLINA EYE AND EAR ASSOCIATES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-14",
        "last_updated": "2008-04-20",
        "status": "A",
        "authorized_official_last_name": "AGOSTO",
        "authorized_official_first_name": "MAGGIE",
        "authorized_official_title_or_position": "BUSINESS MANAGER",
        "authorized_official_telephone_number": "803-744-4103"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Ophthalmology",
            "state": "SC",
            "license": "0689474",
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Otolaryngology",
            "state": "SC",
            "license": "0689474",
            "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 Apr 20, 2008; 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.