NPIMap

Organization Active NPI

Palmetto Eye Associates

Doing business as santee eye clinic

  • Optometrist
  • Santee, SC
National Provider Identifier
1184861411
Registry record updated Jan 8, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1053 Issued in SC
Legal business name
PALMETTO EYE ASSOCIATES
Doing business as
santee eye clinic
Practice address
150 Plaza Circle
Santee, SC 29142
Phone
(803) 854-2682
NPI assigned
Jan 8, 2009
Last updated
Jan 8, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2009

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

Authorized official

Name
Dr. Jeff Pockl
Title
Owner
Phone
(803) 758-0058

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1053 SC Primary

Addresses

Primary practice location

150 Plaza Circle
Santee, SC 29142

Mailing address

PO Box 1030
Holly Hill, SC 29059-1030
Phone (803) 854-2682

Other identifiers 1

IdentifierTypeStateIssuer
DA9713MedicaidSC

Other names 1

  • santee eye clinic Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Palmetto Eye Associates2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

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": "1231372800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1231372800000",
    "number": "1184861411",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1030",
            "city": "HOLLY HILL",
            "state": "SC",
            "postal_code": "290591030",
            "telephone_number": "803-854-2682"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 PLAZA CIRCLE",
            "city": "SANTEE",
            "state": "SC",
            "postal_code": "29142",
            "telephone_number": "803-854-2682"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PALMETTO EYE ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-01-08",
        "last_updated": "2009-01-08",
        "status": "A",
        "authorized_official_last_name": "POCKL",
        "authorized_official_first_name": "JEFF",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "803-758-0058",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "SC",
            "license": "1053",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "DA9713",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "santee eye clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Santee, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 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.