NPIMap

Organization Active NPI

Myeyedr Optometry of South Carolina, LLC

Doing business as MyEyeDr

  • Optometrist
  • Rock Hill, SC
National Provider Identifier
1205248481
Registry record updated May 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
MYEYEDR OPTOMETRY OF SOUTH CAROLINA, LLC
Doing business as
MyEyeDr
Practice address
1268 Ebenezer Rd
Rock Hill, SC 29732
Phone
(803) 817-9755
NPI assigned
May 22, 2014
Last updated
May 24, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 24, 2022

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

Authorized official

Name
Sue Healey
Title
Secretary
Phone
(703) 847-8899

Specialties & licenses 1

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

Addresses

Primary practice location

1268 Ebenezer Rd
Rock Hill, SC 29732

Mailing address

8614 Westwood Center Dr FL 9
Vienna, VA 22182-2442
Phone (703) 847-8899

Other names 1

  • MyEyeDr Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140826001090 SC Part B Supplier - Clinic/Group Practice 3173741618 Receives reassigned benefits from 45 practitioners
16 other NPIs on this enrollment
Practice locations: Summerville, SC; Fort Mill, SC; Rock Hill, SC; Pickens, SC; North Charleston, SC; Mt Pleasant, SC; Manning, SC; Indian Land, SC…

Other NPIs with the same Medicare PAC ID 3

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 16

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 16

National Provider Directory

National Provider Directory

Locations

1025 Woodruff Rd
Ste D104
Greenville, SC 29607
Phone (864) 589-9329

812 W Wade Hampton Blvd
Greer, SC 29650
Phone (864) 877-1825

2601 N Main St
Ste E
Summerville, SC 29486
Phone (843) 502-7705

Practitioners & affiliated clinicians

Practitioners 45

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.

View all 45

NPI Registry JSON

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

{
    "created_epoch": "1400716800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1653350400000",
    "number": "1205248481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8614 WESTWOOD CENTER DR FL 9",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221822442",
            "telephone_number": "703-847-8899",
            "fax_number": "571-223-6780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1268 EBENEZER RD",
            "city": "ROCK HILL",
            "state": "SC",
            "postal_code": "29732",
            "telephone_number": "803-817-9755"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MYEYEDR OPTOMETRY OF SOUTH CAROLINA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-05-22",
        "last_updated": "2022-05-24",
        "certification_date": "2022-05-24",
        "status": "A",
        "authorized_official_last_name": "HEALEY",
        "authorized_official_first_name": "SUE",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "703-847-8899"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MyEyeDr",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "MyEyeDr",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Rock Hill, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2022; 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.