Organization Active NPI

Carolina Clear Vision LLC

  • Optometrist
  • Columbia, SC
National Provider Identifier
1376497610
Registry record updated Feb 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
CAROLINA CLEAR VISION LLC
Practice address
4712 Liberty Division Rd
4712 Liberty Division Rd
Columbia, SC 29207
Phone
(839) 292-6879
Fax
(803) 661-6316
NPI assigned
Feb 24, 2026
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2026

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

Authorized official

Name
Ms. Kashia Raquel Doyle
Title
Manager
Phone
(839) 292-6879

Specialties & licenses 1

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

Addresses

Primary practice location

4712 Liberty Division Rd
4712 Liberty Division Rd
Columbia, SC 29207

Mailing address

4712 Liberty Division Rd
4712 Liberty Division Rd
Columbia, SC 29207
Phone (839) 292-6879

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20260413002232 SC Part B Supplier - Clinic/Group Practice 3173098571 Receives reassigned benefits from 1 practitioner
Practice locations: Columbia, SC

National Provider Directory

National Provider Directory

Locations

4712 Liberty Division Ave
Columbia, SC 29207
Phone (803) 334-0530

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1771891200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1771891200000",
    "number": "1376497610",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4712 LIBERTY DIVISION RD",
            "address_2": "4712 LIBERTY DIVISION RD",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "29207",
            "telephone_number": "839-292-6879",
            "fax_number": "803-661-6316"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4712 LIBERTY DIVISION RD",
            "address_2": "4712 LIBERTY DIVISION RD",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "29207",
            "telephone_number": "839-292-6879",
            "fax_number": "803-661-6316"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAROLINA CLEAR VISION LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-02-24",
        "last_updated": "2026-02-24",
        "certification_date": "2026-02-24",
        "status": "A",
        "authorized_official_last_name": "DOYLE",
        "authorized_official_first_name": "KASHIA",
        "authorized_official_middle_name": "RAQUEL",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "839-292-6879",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2026; 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.