Organization Active NPI

Eyecare Physicians & Surgeons LLC

  • Ophthalmology Physician
  • Charleston, SC
National Provider Identifier
1467595074
Registry record updated May 14, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
EYECARE PHYSICIANS & SURGEONS LLC
Practice address
125 Doughty St
Suite 330
Charleston, SC 29403-5736
Phone
(843) 722-7705
Fax
(843) 722-7149
NPI assigned
Feb 14, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 14, 2008

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

Authorized official

Name
Mrs. Jacquelyn P Hall, COA, CMA
Title
Practice Manager
Phone
(843) 722-7705

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207W00000X Primary

Addresses

Primary practice location

125 Doughty St
Suite 330
Charleston, SC 29403-5736

Mailing address

125 Doughty St
Suite 330
Charleston, SC 29403-5736
Phone (843) 722-7705

Other identifiers 1

IdentifierTypeStateIssuer
GP1975MedicaidSC

National Provider Directory

National Provider Directory

Locations

9217 University Blvd
Ste 1
North Charleston, SC 29406
Phone (843) 574-9818

400 Constance St
Walterboro, SC 29488
Phone (843) 549-2578

Interoperability endpoints

  • Direct secure messaging: akent@espeyecare.intellechartdirect.net
  • Direct secure messaging: jlally@espeyecare.intellechartdirect.net

NPI Registry JSON

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

{
    "created_epoch": "1171411200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1210723200000",
    "number": "1467595074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 DOUGHTY ST",
            "address_2": "SUITE 330",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294035736",
            "telephone_number": "843-722-7705",
            "fax_number": "843-722-7149"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 DOUGHTY ST",
            "address_2": "SUITE 330",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294035736",
            "telephone_number": "843-722-7705",
            "fax_number": "843-722-7149"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYECARE PHYSICIANS & SURGEONS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-14",
        "last_updated": "2008-05-14",
        "status": "A",
        "authorized_official_last_name": "HALL",
        "authorized_official_first_name": "JACQUELYN",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "843-722-7705",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "COA, CMA"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP1975",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2008; 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.