Organization Active NPI

Lifetime Eyecare Associates LLC

  • Optometrist
  • Spartanburg, SC
National Provider Identifier
1164715843
Registry record updated May 27, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1621 Issued in SC
Legal business name
LIFETIME EYECARE ASSOCIATES LLC
Practice address
2428 Reidville Rd
Spartanburg, SC 29301-3652
Phone
(864) 576-7225
Fax
(864) 576-7226
NPI assigned
May 27, 2011
Last updated
May 27, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 27, 2011

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

Authorized official

Name
Dr. Jeremy R Burns, ODNPI 1699889998
Title
President
Phone
(864) 576-7225

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
Optometrist 152W00000X 1621 SC Primary

Addresses

Primary practice location

2428 Reidville Rd
Spartanburg, SC 29301-3652

Mailing address

2428 Reidville Rd
Spartanburg, SC 29301-3652
Phone (864) 576-7225

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110803000052 SC Part B Supplier - Clinic/Group Practice 0648449967 Receives reassigned benefits from 1 practitioner
Practice locations: Spartanburg, SC

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1306454400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1306454400000",
    "number": "1164715843",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2428 REIDVILLE RD",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "293013652",
            "telephone_number": "864-576-7225",
            "fax_number": "864-576-7226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2428 REIDVILLE RD",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "293013652",
            "telephone_number": "864-576-7225",
            "fax_number": "864-576-7226"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFETIME EYECARE ASSOCIATES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-05-27",
        "last_updated": "2011-05-27",
        "status": "A",
        "authorized_official_last_name": "BURNS",
        "authorized_official_first_name": "JEREMY",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "864-576-7225",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "SC",
            "license": "1621",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 May 27, 2011; 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.