NPIMap

Organization Active NPI

Vision Therapy Institute of SC

  • Optometrist
  • West Columbia, SC
National Provider Identifier
1114569795
Registry record updated Aug 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
VISION THERAPY INSTITUTE OF SC
Practice address
3618 Sunset Blvd Ste a
West Columbia, SC 29169-3046
Phone
(803) 732-4099
Fax
(803) 227-8992
NPI assigned
Oct 15, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2021

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

Authorized official

Name
Kate D Tarver, O. D. , FCOVDNPI 1912310897
Title
Owner
Phone
(803) 413-9618

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193200000X MULTI-SPECIALTY GROUP 152W00000X Primary
Vision Therapy OptometristGroup: 193200000X MULTI-SPECIALTY GROUP 152WV0400X

Addresses

Primary practice location

3618 Sunset Blvd Ste a
West Columbia, SC 29169-3046

Mailing address

3618 Sunset Blvd Ste a
West Columbia, SC 29169-3046
Phone (803) 732-4099

Other practice location 1

1620 Browning Rd
Columbia, SC 29210-6924
Phone (803) 732-4099

Other identifiers 1

IdentifierTypeStateIssuer
DA9126MedicaidSC

Other names 1

  • Vision Therapy Institute Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200429000067 SC Part B Supplier - Clinic/Group Practice 5799115044 Receives reassigned benefits from 5 practitioners
Practice locations: West Columbia, SC

National Provider Directory

National Provider Directory

Locations

3618 Sunset Blvd
#A
West Columbia, SC 29169
Phone (803) 732-4099

Practitioners & affiliated clinicians

Practitioners 5

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": "1571097600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1629936000000",
    "number": "1114569795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3618 SUNSET BLVD STE A",
            "city": "WEST COLUMBIA",
            "state": "SC",
            "postal_code": "291693046",
            "telephone_number": "803-732-4099",
            "fax_number": "803-227-8992"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3618 SUNSET BLVD STE A",
            "city": "WEST COLUMBIA",
            "state": "SC",
            "postal_code": "291693046",
            "telephone_number": "803-732-4099",
            "fax_number": "803-227-8992"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1620 Browning Rd",
            "address_purpose": "LOCATION",
            "city": "Columbia",
            "state": "SC",
            "postal_code": "292106924",
            "country_code": "US",
            "telephone_number": "803-732-4099",
            "fax_number": "803-227-8992",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "VISION THERAPY INSTITUTE OF SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-15",
        "last_updated": "2021-08-26",
        "certification_date": "2021-08-26",
        "status": "A",
        "authorized_official_last_name": "TARVER",
        "authorized_official_first_name": "KATE",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "803-413-9618",
        "authorized_official_credential": "O. D. , FCOVD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "152WV0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist, Vision Therapy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "DA9126",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Vision Therapy Institute",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in West Columbia, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2021; 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.