Individual provider Active NPI

Shivangi Patel, OD

  • Optometrist
  • Mt Pleasant, SC
National Provider Identifier
1275130064
Registry record updated Oct 26, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT.2230 Issued in SC
Practice address
709 Long Point Rd Ste C
Mt Pleasant, SC 29464-8287
Phone
(843) 849-0800
Fax
(843) 849-0100
NPI assigned
Oct 5, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPT.2230 SC Primary

Addresses

Primary practice location

709 Long Point Rd Ste C
Mt Pleasant, SC 29464-8287

Mailing address

1950 Old Gallows Rd Ste 520
Vienna, VA 22182-3970
Phone (703) 847-8899

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC, VA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20201104001841 SC Practitioner - Optometry 4981014883 Reassigns benefits to 1 organization
I20240509002591 VA Practitioner - Optometry 4981014883 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPT.2230SCMDOptometrist
2230SCMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Myeyedr Optometry of South Carolina, LLC Optometrist Current Accepting new patients
Repko Family Vision Center, PLLC Optometrist CurrentSince Apr 1, 2024 Accepting new patients
Myeyedr Optometry of South Carolina, LLC Optometrist CurrentSince Nov 2, 2020 Accepting new patients
Myeyedr Optometry South Carolina, LLC Optometrist CurrentSince Nov 2, 2020 Accepting new patients

Locations

709 Long Point Rd
Ste C
Mt Pleasant, SC 29464
Phone (843) 259-2002

7643 Rivers Ave
Ste D
North Charleston, SC 29406
Phone (843) 797-0731

1268 Ebenezer Rd
Rock Hill, SC 29732
Phone (803) 327-2001

241 Gateway Plz
Ste 106
Gate City, VA 24251
Phone (276) 690-2345

1950 Old Gallows Rd
Ste 520
Vienna, VA 22182

8614 Westwood Center Dr
Fl 9
Vienna, VA 22182

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1601856000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603670400000",
    "number": "1275130064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1950 OLD GALLOWS RD STE 520",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221823970",
            "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": "709 LONG POINT RD STE C",
            "city": "MT PLEASANT",
            "state": "SC",
            "postal_code": "294648287",
            "telephone_number": "843-849-0800",
            "fax_number": "843-849-0100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "SHIVANGI",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-05",
        "last_updated": "2020-10-26",
        "certification_date": "2020-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "SC",
            "license": "OPT.2230",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mt Pleasant, SC

Sources for this page

Verify at the official NPI Registry.