Evon Y Eichelberger, LICENSED OPTICIAN

Primary specialty

OpticianTaxonomy code 156FX1800X

License

851 Issued in SC

Practice address

2024 Bear Village CT
Newberry, SC 29108-2200

Phone

(803) 321-0715

Fax

(803) 321-0718

NPI assigned

Jan 8, 2009

Last updated

Jan 8, 2009By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1231372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1231372800000",
    "number": "1265679542",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2024 BEAR VILLAGE CT",
            "city": "NEWBERRY",
            "state": "SC",
            "postal_code": "291082200",
            "telephone_number": "803-321-0715",
            "fax_number": "803-321-0718"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2024 BEAR VILLAGE CT",
            "city": "NEWBERRY",
            "state": "SC",
            "postal_code": "291082200",
            "telephone_number": "803-321-0715",
            "fax_number": "803-321-0718"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EICHELBERGER",
        "first_name": "EVON",
        "middle_name": "Y",
        "name_prefix": "Mrs.",
        "credential": "LICENSED OPTICIAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-01-08",
        "last_updated": "2009-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Optician",
            "state": "SC",
            "license": "851",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mark Patrick Ezekiel, M.D
• Family Dentistry of Newberry

• Optician in Newberry, SC
• Providers in Newberry, SC by specialty
• Optician in South Carolina

• 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.