NPIMap

Organization Active NPI

Southern Eye Associates of SC, PA

  • Eyewear Supplier
  • Clemson, SC
National Provider Identifier
1467228080
Registry record updated Nov 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Eyewear SupplierTaxonomy code 332H00000X
Legal business name
SOUTHERN EYE ASSOCIATES OF SC, PA
Practice address
161 Thomas Green Blvd
Clemson, SC 29631-2166
Phone
(864) 269-3333
NPI assigned
Nov 27, 2023
Last updated
Nov 27, 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 Nov 27, 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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Eyewear Supplier 332H00000X Primary

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

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250612001596 SC DME Supplier - Physician - Ophthalmology 4183681356 Practice locations: Clemson, SC

Other NPIs with the same Medicare PAC ID 4

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Southern Eye Assoc PA8 organizations share this tax ID, including this one
Part of
Southern Eye Assoc PA

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

10121 Clemson Blvd
Seneca, SC 29678
Phone (864) 269-3333

Practitioners & affiliated clinicians

Practitioners 21

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.

View all 21

NPI Registry JSON

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

{
    "created_epoch": "1701043200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701043200000",
    "number": "1467228080",
    "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"
        },
        {
            "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"
        }
    ],
    "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": "2023-11-27",
        "last_updated": "2023-11-27",
        "certification_date": "2023-11-27",
        "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": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "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 Nov 27, 2023; 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.