Individual provider Active NPI

Rufus Bedford Antley, O.D.

  • Optometrist
  • Batesburg, SC
National Provider Identifier
1306835582
Registry record updated Feb 26, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
433 Issued in SC
Practice address
117 W Church St
Batesburg, SC 29006-2108
Phone
(803) 532-9870
Fax
(803) 532-1259
NPI assigned
Oct 19, 2005
Last updated
Feb 26, 2008By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 26, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 433 SC Primary

Addresses

Primary practice location

117 W Church St
Batesburg, SC 29006-2108

Mailing address

117 W Church St
Batesburg, SC 29006-2108
Phone (803) 532-9870

Other identifiers 3

IdentifierTypeStateIssuer
0652760001OtherSCDMERC
570629655-002OtherSCTRICARE
D04332MedicaidSC

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
I20040114000149 SC Practitioner - Optometry 4385545391 Practice locations: Batesburg, SC; Wagener, SC

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 1960
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

117 W Church St
Batesburg, SC 29006-2108
Phone (803) 532-9870

149 Main N St
Wagener, SC 29164-8736
Phone (803) 564-6728

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Rufus B. Antley, O.D. Optometrist PastSince Jan 1, 1990 Accepting new patients
Eye Associates of Cayce - West Columbia Optometrist PastSince Mar 10, 2024 Accepting new patients
Eye Associates of Cayce - West Columbia Optometrist Past Accepting new patients

Organizations & group practices 3

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": "1129680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1203984000000",
    "number": "1306835582",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 W CHURCH ST",
            "city": "BATESBURG",
            "state": "SC",
            "postal_code": "290062108",
            "telephone_number": "803-532-9870",
            "fax_number": "803-532-1259"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "117 W CHURCH ST",
            "city": "BATESBURG",
            "state": "SC",
            "postal_code": "290062108",
            "telephone_number": "803-532-9870",
            "fax_number": "803-532-1259"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANTLEY",
        "first_name": "RUFUS",
        "middle_name": "BEDFORD",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-19",
        "last_updated": "2008-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "SC",
            "license": "433",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DMERC",
            "identifier": "0652760001",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "570629655-002",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "D04332",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Batesburg, SC

Sources for this page

Verify at the official NPI Registry.