Jevaughn Gibbs, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPT003727 Issued in GA

Practice address

109 Finnegan CT
Myrtle Beach, SC 29579-4205

Phone

(843) 903-0949

NPI assigned

May 5, 2025

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

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

Specialty

Optometry

Education

Illinois College of Optometry at Chicago, 2025

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Seaside Eye Associates P aGroup PAC ID 7012920887, 2 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Seaside Eye Associates P a

  • Optometrist
  • Myrtle Beach, SC
  • NPI 1275894750
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1746403200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782172800000",
    "number": "1124817218",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 FINNEGAN CT",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295794205",
            "telephone_number": "843-903-0949"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 FINNEGAN CT",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295794205",
            "telephone_number": "843-903-0949"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8075 Mall Pkwy Ste 103",
            "address_purpose": "LOCATION",
            "city": "Lithonia",
            "state": "GA",
            "postal_code": "300386993",
            "country_code": "US",
            "telephone_number": "770-484-2955",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GIBBS",
        "first_name": "JEVAUGHN",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-05-05",
        "last_updated": "2026-06-23",
        "certification_date": "2026-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "GA",
            "license": "OPT003727",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CO",
            "license": "OPT.0004171",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "SC",
            "license": "2549",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Get Mobile Physical Therapy LLC
• Anita D Giardino, OT
• Erica Leanne Gibbons, DO
• Jacqueline Gibbons
• Brittany Gibbs, SSP, LPES, RN
• Sean L. Gibbs, M.D.
• Troy Gibson
• Valda Gibson, M.D.
• Eugene M. Giddens, MD
• Shelley M Gilbert, RPA-C

• Optometrist in Myrtle Beach, SC
• Providers in Myrtle Beach, SC by specialty
• Optometrist in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.