Blue Rose Eye Care PA

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

BLUE ROSE EYE CARE PA

Practice address

2304 W Parker Rd
Greenville, SC 29617-2123

Phone

(864) 246-0964

Fax

(864) 246-2757

NPI assigned

Apr 12, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Whitney R O'Brian, ODNPI 1235491515

Title

Owner/Optometrist

Phone

(864) 246-0964

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• YEAGER VISION CARE Former legal business name

Medicare fee-for-service enrollment

Enrolled in SC

Enrollment records 1

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Whitney O'Brian, O.D.

  • Optometrist
  • Greenville, SC
  • NPI 1235491515
  Medicare reassignment NPD Authorized official
• Cynthia W Yeager, OD

  • Optometrist
  • Greenville, SC
  • NPI 1801923487
  Medicare reassignment NPD
• Kenneth Anthony Yeager

  • Optometrist
  • Greenville, SC
  • NPI 1568412344
  Medicare reassignment NPD

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

{
    "created_epoch": "1176336000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1714435200000",
    "number": "1306060199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2304 W PARKER RD",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296172123",
            "telephone_number": "864-246-0964",
            "fax_number": "864-246-2757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2304 W PARKER RD",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296172123",
            "telephone_number": "864-246-0964",
            "fax_number": "864-246-2757"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUE ROSE EYE CARE PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-12",
        "last_updated": "2024-04-30",
        "certification_date": "2024-04-30",
        "status": "A",
        "authorized_official_last_name": "O'BRIAN",
        "authorized_official_first_name": "WHITNEY",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER/OPTOMETRIST",
        "authorized_official_telephone_number": "864-246-0964",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "SC",
            "license": "1027",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "D10272",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "D17060",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Yeager Vision Care",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Yeager Vision Care",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "YEAGER VISION CARE",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Gayle Smith Blouin, M.D.
• Randall Richard Blouin, M.D.
• Howard Paul Blount III, MD
• Blue Mountain Diagnostics LLC
• Blue Ridge Health LLC
• Kali M Blue, E.D.S, LPCA, NCC
• Kecia House Blue, RN
• Tracie Blue
• Blueprint Wellness and Consulting Services LLC
• Nicole G Blum

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2024; 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.