Individual provider Active NPI

Ellesse Keefer, O.D.

  • Optometrist
  • Mount Pleasant, SC
National Provider Identifier
1306256003
Registry record updated Oct 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1857 Issued in SC
Practice address
735 Johnnie Dodds Blvd Ste 101
Mt Pleasant, SC 29464-3060
Phone
(843) 592-3955
NPI assigned
May 2, 2014
Last updated
Oct 2, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 2, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1857 SC Primary

Addresses

Primary practice location

735 Johnnie Dodds Blvd Ste 101
Mt Pleasant, SC 29464-3060

Mailing address

735 Johnnie Dodds Blvd Ste 101
Mount Pleasant, SC 29464-3060
Phone (843) 592-3955

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20160105002858 SC Practitioner - Optometry 7719289941 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southeastern Vision Institute LLCGroup PAC ID 6709153950, 4 clinicians

Practice addresses (Care Compare)

735 Johnnie Dodds Blvd
Suite 101
Mount Pleasant, SC 29464-3060
Phone (843) 216-2020

Merit-based Incentive Payment System (MIPS)

Final score
86.67 of 100Reported as group
Quality
97.88
Improvement activities
40
Cost
58.41

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1857SCMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Southeastern Vision Institute LLC CurrentSince Aug 1, 2021 Accepting new patients

Locations

735 Johnnie Dodds Blvd
Ste 101
Mt Pleasant, SC 29464
Phone (843) 216-2020

Interoperability endpoints

  • Direct secure messaging: eboiwka@waringvision.emadirect.md

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1398988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790899200000",
    "number": "1306256003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "735 JOHNNIE DODDS BLVD STE 101",
            "city": "MOUNT PLEASANT",
            "state": "SC",
            "postal_code": "294643060",
            "telephone_number": "843-592-3955"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "735 JOHNNIE DODDS BLVD STE 101",
            "city": "MT PLEASANT",
            "state": "SC",
            "postal_code": "294643060",
            "telephone_number": "843-592-3955"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEEFER",
        "first_name": "ELLESSE",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-05-02",
        "last_updated": "2026-10-02",
        "certification_date": "2026-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "SC",
            "license": "1857",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Pleasant, SC

Sources for this page

Verify at the official NPI Registry.