Individual provider Active NPI

Kaitlyn Greiner, OD

  • Optometrist
  • Mt Pleasant, SC
National Provider Identifier
1417575341
Registry record updated Sep 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2373 Issued in SC
Practice address
735 Johnnie Dodds Blvd Ste 101
Mt Pleasant, SC 29464-3060
Phone
(843) 216-2020
Fax
(843) 410-7018
NPI assigned
Jul 7, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2373 SC Primary

Addresses

Primary practice location

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

Mailing address

1171 Southgate Dr
Charleston, SC 29407-4209
Phone (843) 906-6966

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
I20220929001812 SC Practitioner - Optometry 2365866795 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

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
2373SCMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Southeastern Vision Institute LLC CurrentSince Oct 3, 2022 Accepting new patients

Locations

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

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": "1594080000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663286400000",
    "number": "1417575341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1171 SOUTHGATE DR",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294074209",
            "telephone_number": "843-906-6966"
        },
        {
            "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": "843-216-2020",
            "fax_number": "843-410-7018"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREINER",
        "first_name": "KAITLYN",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-07",
        "last_updated": "2022-09-16",
        "certification_date": "2022-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "SC",
            "license": "2373",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mt Pleasant, SC

Sources for this page

Verify at the official NPI Registry.