Organization Active NPI

Stephen Buck

  • Optometrist
  • Spartanburg, SC
National Provider Identifier
1295850824
Registry record updated Jul 3, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
591 Issued in SC
Legal business name
STEPHEN BUCK
Practice address
1855 E Main St
Ste 14, TMB 151
Spartanburg, SC 29307-2309
Phone
(252) 985-1371
NPI assigned
Mar 20, 2007
Last updated
Jul 3, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2008

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

Authorized official

Name
Stephen G Buck, OD
Title
Optometrist
Phone
(252) 985-1371

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 591 SC Primary

Addresses

Primary practice location

1855 E Main St
Ste 14, TMB 151
Spartanburg, SC 29307-2309

Mailing address

P O Box 7396
Rocky Mount, NC 27804-4837

Other identifiers 2

IdentifierTypeStateIssuer
D05910MedicaidSC
P00308477OtherSCRR MEDICARE PROV #

National Provider Directory

National Provider Directory

Locations

1855 E Main St
Ste 14
Spartanburg, SC 29307
Phone (828) 754-8886

NPI Registry JSON

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

{
    "created_epoch": "1174348800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1215043200000",
    "number": "1295850824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P O BOX 7396",
            "city": "ROCKY MOUNT",
            "state": "NC",
            "postal_code": "278044837"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1855 E MAIN ST",
            "address_2": "STE 14, TMB 151",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "293072309",
            "telephone_number": "252-985-1371"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STEPHEN BUCK",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-20",
        "last_updated": "2008-07-03",
        "status": "A",
        "authorized_official_last_name": "BUCK",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "252-985-1371",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "SC",
            "license": "591",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "D05910",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE PROV #",
            "identifier": "P00308477",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Spartanburg, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2008; 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.