NPIMap

Organization Active NPI

Southern Eye Associates of SC, PA

  • Ophthalmology Physician
  • Clemson, SC
National Provider Identifier
1467225714
Registry record updated Oct 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
SOUTHERN EYE ASSOCIATES OF SC, PA
Practice address
161 Thomas Green Blvd
Clemson, SC 29631-2166
Phone
(864) 269-3333
Fax
(864) 626-0757
NPI assigned
Oct 30, 2023
Last updated
Oct 30, 2023By the provider in NPPES
Organization subpart
Yes
Parent organization
SOUTHERN EYE ASSOCIATES OF SC, PAAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 30, 2023

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

Authorized official

Name
Denise Rivera
Title
Billing Supervisor
Phone
(864) 268-3341

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X NU
Ophthalmology Physician 207W00000X NU Primary
Ophthalmic Plastic and Reconstructive Surgery Physician 207WX0200X NU
Cornea and External Diseases Specialist Physician 207WX0120X NU
Glaucoma Specialist (Ophthalmology) Physician 207WX0009X NU
Retina Specialist (Ophthalmology) Physician 207WX0107X NU

Addresses

Primary practice location

161 Thomas Green Blvd
Clemson, SC 29631-2166

Mailing address

113 Doctors Dr
Greenville, SC 29605-5608
Phone (864) 269-3333

National Provider Directory

National Provider Directory
Tax ID family
Southern Eye Assoc of SC8 organizations share this tax ID, including this one
Part of
Southern Eye Assoc of SC

Other organizations with this tax ID 7

Organizations that report the same tax identification number in the National Provider Directory.

Locations

161 Thomas Green Blvd
Clemson, SC 29631
Phone (864) 269-3333

NPI Registry JSON

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

{
    "created_epoch": "1698624000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1698624000000",
    "number": "1467225714",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "113 DOCTORS DR",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296055608",
            "telephone_number": "864-269-3333",
            "fax_number": "864-626-0757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "161 THOMAS GREEN BLVD",
            "city": "CLEMSON",
            "state": "SC",
            "postal_code": "296312166",
            "telephone_number": "864-269-3333",
            "fax_number": "864-626-0757"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN EYE ASSOCIATES OF SC, PA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SOUTHERN EYE ASSOCIATES OF SC, PA",
        "enumeration_date": "2023-10-30",
        "last_updated": "2023-10-30",
        "certification_date": "2023-10-30",
        "status": "A",
        "authorized_official_last_name": "RIVERA",
        "authorized_official_first_name": "DENISE",
        "authorized_official_title_or_position": "BILLING SUPERVISOR",
        "authorized_official_telephone_number": "864-268-3341"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207WX0200X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Ophthalmic Plastic and Reconstructive Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207WX0120X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Cornea and External Diseases Specialist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207WX0009X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Glaucoma Specialist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207WX0107X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Retina Specialist",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clemson, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.