Individual provider Active NPI

Kendria L Cartledge, OD

  • Optometrist
  • Columbia, SC
National Provider Identifier
1114245081
Registry record updated May 17, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
PENDING Issued in SC
Practice address
1513 Gregg St
Columbia, SC 29201-3529
Phone
(803) 254-4951
Fax
(803) 254-4952
NPI assigned
May 17, 2010
Last updated
May 17, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 17, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X PENDING SC Primary

Addresses

Primary practice location

1513 Gregg St
Columbia, SC 29201-3529

Mailing address

1648 McCaw Rd
Columbia, SC 29204-3012
Phone (803) 422-9729

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
I20100923001518 SC Practitioner - Optometry 1254457583 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1513 Gregg St
Columbia, SC 29201-3529
Phone (803) 254-4951

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery18

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PENDINGSCMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Insyte LLC Optometrist CurrentSince Apr 5, 2014 Accepting new patients

Locations

1513 Gregg St
Columbia, SC 29201
Phone (803) 254-4951

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1274054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1274054400000",
    "number": "1114245081",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1648 MCCAW RD",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292043012",
            "telephone_number": "803-422-9729",
            "fax_number": "803-254-4952"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1513 GREGG ST",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292013529",
            "telephone_number": "803-254-4951",
            "fax_number": "803-254-4952"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARTLEDGE",
        "first_name": "KENDRIA",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-05-17",
        "last_updated": "2010-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "SC",
            "license": "PENDING",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, SC

Sources for this page

Verify at the official NPI Registry.