Montague Eye Center LLC

Primary specialty

OptometristTaxonomy code 152W00000X

License

1280 Issued in SC

Legal business name

MONTAGUE EYE CENTER LLC

Practice address

711 Montague Ave
Greenwood, SC 29649

Phone

(864) 229-2301

Fax

(864) 229-1898

NPI assigned

May 4, 2007

Last updated

Dec 18, 2007By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Jennifer R Lippens, ODNPI 1942269576

Title

Owner

Phone

(864) 229-2301

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in SC

Enrollment records 1

Locations

Practitioners 4

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.

• Jennifer R Lippens, O.D.

  • Optometrist
  • Greenwood, SC
  • NPI 1942269576
  Medicare reassignment Care Compare group Authorized official
• Zachary A Barnard, O.D.

  • Optometrist
  • Greenwood, SC
  • NPI 1417847872
  Medicare reassignment Care Compare group NPD
• Kara Jo Dodgens, O.D.

  • Optometrist
  • Easley, SC
  • NPI 1710186572
  NPD (past)
• Jeffrey C Rockwell, O.D.

  • Optometrist
  • Greenwood, SC
  • NPI 1760442651
  NPD (past)

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

{
    "created_epoch": "1178236800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1197936000000",
    "number": "1205048964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "711 MONTAGUE AVE",
            "address_2": "PO BOX 1206",
            "city": "GREENWOOD",
            "state": "SC",
            "postal_code": "29649",
            "telephone_number": "864-229-2301",
            "fax_number": "864-229-1898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "711 MONTAGUE AVE",
            "city": "GREENWOOD",
            "state": "SC",
            "postal_code": "29649",
            "telephone_number": "864-229-2301",
            "fax_number": "864-229-1898"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MONTAGUE EYE CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-04",
        "last_updated": "2007-12-18",
        "status": "A",
        "authorized_official_last_name": "LIPPENS",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "864-229-2301",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "SC",
            "license": "1280",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "DA9714",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE GROUP#",
            "identifier": "DB0813",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Holly Melinda Mize, PHARMD
• Karen M. Mogab, LMSW
• Rumesha Momin, PA-C
• Clifford A Monda, D.O.
• Gail L Monson, APRN
• Justin D Moody, MD
• Valerie K Moody, MD
• Laura Diane Moon
• Angelica Moore
• Dwight Michael Moore

• Optometrist in Greenwood, SC
• Providers in Greenwood, SC by specialty
• Optometrist in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2007; 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.