3 D Optometry PC

Primary specialty

OptometristTaxonomy code 152W00000X

License

1350 Issued in SC

Legal business name

3 D OPTOMETRY PC

Practice address

1031 Highway 41 Ste 400
Mt Pleasant, SC 29466-9320

Phone

(843) 388-1888

Fax

(843) 856-9643

NPI assigned

Dec 12, 2006

Last updated

Jun 21, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Thomas J Mirabile, ODNPI 1679538284

Title

Presdient

Phone

(843) 388-1888

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in SC

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Thomas Joseph Mirabile, OD

  • Optometrist
  • Mount Pleasant, SC
  • NPI 1679538284
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1165881600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529539200000",
    "number": "1376604546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1031 HIGHWAY 41 STE 400",
            "city": "MT PLEASANT",
            "state": "SC",
            "postal_code": "294669320",
            "telephone_number": "843-388-1888",
            "fax_number": "843-856-9643"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1031 HIGHWAY 41 STE 400",
            "city": "MT PLEASANT",
            "state": "SC",
            "postal_code": "294669320",
            "telephone_number": "843-388-1888",
            "fax_number": "843-856-9643"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "3 D OPTOMETRY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-12",
        "last_updated": "2018-06-21",
        "status": "A",
        "authorized_official_last_name": "MIRABILE",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESDIENT",
        "authorized_official_telephone_number": "843-388-1888",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "SC",
            "license": "1350",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Optometrist in Mount Pleasant, SC
• Providers in Mount Pleasant, SC by specialty
• Optometrist in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2018; 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.