Organization Active NPI

Eye2Eye Vision Care, LLC

  • Optometrist
  • Mount Pleasant, SC
National Provider Identifier
1447741376
Registry record updated Jul 10, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
EYE2EYE VISION CARE, LLC
Practice address
3525 Park Avenue Blvd
Mount Pleasant, SC 29466
Phone
(843) 327-4000
Fax
(843) 501-7236
NPI assigned
May 26, 2018
Last updated
Jul 10, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2018

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

Authorized official

Name
Dr. Leslie Kirk, ODNPI 1871721910
Title
Optometrist
Phone
(843) 513-8722

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X Primary

Addresses

Primary practice location

3525 Park Avenue Blvd
Mount Pleasant, SC 29466

Mailing address

2362 Stevenson Dr
Charleston, SC 29414-7138
Phone (843) 513-8722

Other identifiers 1

IdentifierTypeStateIssuer
1871721910OtherSCOPTOMETRIST

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180927001613 SC Part B Supplier - Clinic/Group Practice 0244581437 Receives reassigned benefits from 1 practitioner
Practice locations: Mount Pleasant, SC

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1527292800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1531180800000",
    "number": "1447741376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2362 STEVENSON DR",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294147138",
            "telephone_number": "843-513-8722",
            "fax_number": "843-501-7236"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3525 PARK AVENUE BLVD",
            "city": "MOUNT PLEASANT",
            "state": "SC",
            "postal_code": "29466",
            "telephone_number": "843-327-4000",
            "fax_number": "843-501-7236"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYE2EYE VISION CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-05-26",
        "last_updated": "2018-07-10",
        "status": "A",
        "authorized_official_last_name": "KIRK",
        "authorized_official_first_name": "LESLIE",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "843-513-8722",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OPTOMETRIST",
            "identifier": "1871721910",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Pleasant, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 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.