Individual provider Active NPI

Robert M Kriegshaber, O.D.

  • Optometrist
  • Columbia, SC
National Provider Identifier
1467410696
Registry record updated Jun 16, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
SC 850 Issued in SC
Practice address
100 Columbiana Cir
Suite 101
Columbia, SC 29212-2231
Phone
(803) 732-7650
NPI assigned
May 4, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 16, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X SC 850 SC Primary

Addresses

Primary practice location

100 Columbiana Cir
Suite 101
Columbia, SC 29212-2231

Mailing address

2124 Bee Ridge Rd
Columbia, SC 29223-6705
Phone (803) 788-5367

Other identifiers 1

IdentifierTypeStateIssuer
D08506MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SC 850SCMDOptometrist

NPI Registry JSON

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

{
    "created_epoch": "1146700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1276646400000",
    "number": "1467410696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2124 BEE RIDGE RD",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292236705",
            "telephone_number": "803-788-5367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 COLUMBIANA CIR",
            "address_2": "SUITE 101",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292122231",
            "telephone_number": "803-732-7650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRIEGSHABER",
        "first_name": "ROBERT",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-04",
        "last_updated": "2010-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "SC",
            "license": "SC 850",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "D08506",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2010; 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.