Organization Active NPI

Donald J. Kamer, O.D. LLC

  • Optometrist
  • Spartanburg, SC
National Provider Identifier
1154804979
Registry record updated Sep 7, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1936 Issued in SC
Legal business name
DONALD J. KAMER, O.D. LLC
Practice address
404 McCravy Dr Ste B
Spartanburg, SC 29303-3178
Phone
(864) 585-2249
NPI assigned
Sep 7, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 7, 2018

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

Authorized official

Name
Dr. Donald James Kamer, ODNPI 1164416020
Title
Owner
Phone
(614) 352-3738

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 1936 SC Primary

Addresses

Primary practice location

404 McCravy Dr Ste B
Spartanburg, SC 29303-3178

Mailing address

384 Lakeland Dr
Pisgah Forest, NC 28768-9871

Other identifiers 1

IdentifierTypeStateIssuer
D19362MedicaidSC

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20181023002818 SC Part B Supplier - Clinic/Group Practice 8426301359 Receives reassigned benefits from 1 practitioner
Practice locations: Spartanburg, SC

National Provider Directory

National Provider Directory

Locations

404 McCravy Dr
Ste B
Spartanburg, SC 29303
Phone (864) 283-9573

Practitioners & affiliated clinicians

Practitioners 1

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": "1536278400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1536278400000",
    "number": "1154804979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "384 LAKELAND DR",
            "city": "PISGAH FOREST",
            "state": "NC",
            "postal_code": "287689871"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "404 MCCRAVY DR STE B",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "293033178",
            "telephone_number": "864-585-2249"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DONALD J. KAMER, O.D. LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-09-07",
        "last_updated": "2018-09-07",
        "status": "A",
        "authorized_official_last_name": "KAMER",
        "authorized_official_first_name": "DONALD",
        "authorized_official_middle_name": "JAMES",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "614-352-3738",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "SC",
            "license": "1936",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "D19362",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Spartanburg, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2018; 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.