Carolina Specialty Eye Surgery, LLC

Primary specialty

Ophthalmologic Surgery Clinic/CenterTaxonomy code 261QS0132X

Legal business name

CAROLINA SPECIALTY EYE SURGERY, LLC

Practice address

1530 Boiling Springs Rd
Boiling Springs, SC 29316-5121

Phone

(864) 583-6381

NPI assigned

Apr 17, 2020

Last updated

Apr 29, 2020By 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

Mrs. Tammy Fox Duvall, MBA, BSN, RN

Title

Clinical Director

Phone

(864) 583-6381

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in SC

Enrollment records 1

Listed as

Carolina Specialty Eye SurgeryCCN 42C0001095

Medicare certification status

ActiveFrom the Provider of Services file

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Palmetto Eye & Laser Center, LLC

  • Ophthalmology Physician
  • Boiling Springs, SC
  • NPI 1457384729

  Member Of

  NPD member

Locations

Practitioners 9

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.

• Matthew Wade Bickford, MD

  • Ophthalmology Physician
  • Boiling Springs, SC
  • NPI 1750841383
  Medicare reassignment NPD
• Jake P Bostrom, M.D.

  • Ophthalmology Physician
  • Boiling Springs, SC
  • NPI 1295886125
  Medicare reassignment NPD
• Brice B. Dille, M.D.

  • Ophthalmology Physician
  • Boiling Springs, SC
  • NPI 1437151990
  Medicare reassignment NPD
• Billy J Haguewood Jr., M.D.

  • Ophthalmology Physician
  • Boiling Springs, SC
  • NPI 1992708135
  Medicare reassignment NPD
• Karen Leanne Wickliffe-Keisler, M.D.

  • Ophthalmology Physician
  • Boiling Springs, SC
  • NPI 1235333634
  Medicare reassignment NPD
• Jennifer L Winstead, CPHT

  • Pharmacy Technician
  • Chesnee, SC
  • NPI 1679726210
  NPD
• Todd D Gwin, MD

  • Ophthalmology Physician
  • Boiling Springs, SC
  • NPI 1225030208
  NPD (past)
• Michael W Holmes, M.D.

  • Ophthalmology Physician
  • Spartanburg, SC
  • NPI 1063415214
  NPD (past)
• John Stephen McPhail II, OD

  • Optometrist
  • Florence, SC
  • NPI 1568566719
  NPD (past)

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

{
    "created_epoch": "1587081600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1588118400000",
    "number": "1447870688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1530 BOILING SPRINGS RD",
            "city": "BOILING SPRINGS",
            "state": "SC",
            "postal_code": "293165121",
            "telephone_number": "864-583-6381"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1530 BOILING SPRINGS RD",
            "city": "BOILING SPRINGS",
            "state": "SC",
            "postal_code": "293165121",
            "telephone_number": "864-583-6381"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAROLINA SPECIALTY EYE SURGERY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-04-17",
        "last_updated": "2020-04-29",
        "certification_date": "2020-04-29",
        "status": "A",
        "authorized_official_last_name": "DUVALL",
        "authorized_official_first_name": "TAMMY",
        "authorized_official_middle_name": "FOX",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "864-583-6381",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MBA, BSN, RN"
    },
    "taxonomies": [
        {
            "code": "261QS0132X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ophthalmologic Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rebecca Joy Brown, PNP
• Chandler Lane Burnett
• Danny Burnside Sr., M.DIV., M.A. PH. D.
• Carebridge Adult Day Care Center LLC
• Carolina Children's Clinic, LLC
• Lisa Lenore Ruppert Carroll, MD
• Carson Moore LLC
• Matthew Robert Carter, PA-C
• Christian Chapman, LCSW
• Tiffany Cherice Chapman, DC

• Ophthalmologic Surgery Clinic/Center in Boiling Springs, SC
• Providers in Boiling Springs, SC by specialty
• Ophthalmologic Surgery Clinic/Center in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.