Walter A. Mayo, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

805 Issued in SC

Practice address

1200 Highmarket St
Suite 200
Georgetown, SC 29440-3227

Phone

(843) 546-8421

Fax

(843) 546-1173

NPI assigned

Jul 27, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in SC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Coastal Eye Group, P.C.

  • Ophthalmology Physician
  • Georgetown, SC
  • NPI 1821142720
  Medicare reassignment NPD
• Coastal Eye Group, P.C.

  • Ophthalmology Physician
  • Myrtle Beach, SC
  • NPI 1477663706
  NPD

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

{
    "created_epoch": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1205850781",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 HIGHMARKET ST",
            "address_2": "SUITE 200",
            "city": "GEORGETOWN",
            "state": "SC",
            "postal_code": "294403227",
            "telephone_number": "843-546-8421",
            "fax_number": "843-546-1173"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 HIGHMARKET ST",
            "address_2": "SUITE 200",
            "city": "GEORGETOWN",
            "state": "SC",
            "postal_code": "294403227",
            "telephone_number": "843-546-8421",
            "fax_number": "843-546-1173"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAYO",
        "first_name": "WALTER",
        "middle_name": "A.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-27",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "SC",
            "license": "805",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "D08052",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• John J Manning, M.D.
• Kristy Marshall, OTR/L
• Jerry Nell Martin, RN
• Brian L Maxwell, CACII, NCACI
• Eugene V Mayeaux II, M.D.
• McCrea Ewart MD PA
• McCrea Ewart MD PA
• Dalzell Ginn McDilda, M.ED.CCC-SLP
• Deborah R. McKee, C.N.M.
• Edna Elizabeth McMillan, RN, BSN,CDE

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.