Goose Creek Vision Center, Inc.

Primary specialty

OptometristTaxonomy code 152W00000X

License

SC568 Issued in SC

Legal business name

GOOSE CREEK VISION CENTER, INC.

Practice address

425 Redbank Rd
Goose Creek, SC 29445-4505

Phone

(843) 797-1264

Fax

(843) 764-3602

NPI assigned

Nov 8, 2005

Organization subpart

No

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

Authorized official

Name

Dr. Melvin B. Watsky, O.D.

Title

Optometrist

Phone

(843) 797-1264

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Dr. Melvin B. Watsky, Optometrist Doing business as

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

{
    "created_epoch": "1131408000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1237852800000",
    "number": "1114908092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "425 REDBANK RD",
            "city": "GOOSE CREEK",
            "state": "SC",
            "postal_code": "294454505",
            "telephone_number": "843-797-1264",
            "fax_number": "843-764-3602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 REDBANK RD",
            "city": "GOOSE CREEK",
            "state": "SC",
            "postal_code": "294454505",
            "telephone_number": "843-797-1264",
            "fax_number": "843-764-3602"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOOSE CREEK VISION CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-08",
        "last_updated": "2009-03-24",
        "status": "A",
        "authorized_official_last_name": "WATSKY",
        "authorized_official_first_name": "MELVIN",
        "authorized_official_middle_name": "B.",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "843-797-1264",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "SC",
            "license": "SC568",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "DA9765",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK BC/BS GROUP #",
            "identifier": "WA260115",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dr. Melvin B. Watsky, Optometrist",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Richard Goodman II
• Goose Creek Dental Care LLC
• Goose Creek Family Dentistry LLC
• Goose Creek Imagining, LLC
• Goose Creek Physical Medicine LLC
• Bobby Gene Gore, D.D.S.
• Tyrese Mykeil Grant
• Christopher J Gray, DC
• Gray'S Pain Relief Center, LLC
• Arkeem Green

• Optometrist in Goose Creek, SC
• Providers in Goose Creek, SC by specialty
• Optometrist in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.