Individual provider Active NPI

Gary Brant Sweet, OD

  • Optometrist
  • Greenwood, SC
National Provider Identifier
1366470742
Registry record updated Mar 14, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
675 Issued in SC
Practice address
720 Montague Ave
PMB 373
Greenwood, SC 29649
Phone
(864) 223-5051
NPI assigned
Jun 28, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 675 SC Primary

Addresses

Primary practice location

720 Montague Ave
PMB 373
Greenwood, SC 29649

Mailing address

720 Montague Ave
PMB 373
Greenwood, SC 29649
Phone (864) 223-5051

Other identifiers 1

IdentifierTypeStateIssuer
D06754MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
675SCMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Rebecca Vision LLC Optometrist CurrentSince Dec 12, 2012 Accepting new patients

Locations

1230 Amelia St
Orangeburg, SC 29115
Phone (803) 531-0061

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1151452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1457913600000",
    "number": "1366470742",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "720 MONTAGUE AVE",
            "address_2": "PMB 373",
            "city": "GREENWOOD",
            "state": "SC",
            "postal_code": "29649",
            "telephone_number": "864-223-5051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "720 MONTAGUE AVE",
            "address_2": "PMB 373",
            "city": "GREENWOOD",
            "state": "SC",
            "postal_code": "29649",
            "telephone_number": "864-223-5051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SWEET",
        "first_name": "GARY",
        "middle_name": "BRANT",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-28",
        "last_updated": "2016-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "SC",
            "license": "675",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "D06754",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenwood, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2016; 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.