Active NPI
David G Porter, OPTOMETRIST
- Optometrist
- Anderson, SC
National Provider Identifier
1477534782
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 642
- Practice address
- 1220 N Fant St
Anderson, SC 29621-4822 - Phone
- (864) 226-6005
- Fax
- (864) 225-1139
- NPI assigned
- Nov 14, 2005
- Last updated
- Oct 15, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 642 | SC | Primary |
Addresses
Primary practice location
1220 N Fant St
Anderson, SC 29621-4822
Mailing address
PO Box 838
Anderson, SC 29622-0838
Phone (864) 224-8707
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in SC
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Anderson Optometric Associates | Optometrist | Current | Accepting new patients |
| Anderson Optometric Associates | Optometrist | Current | Accepting new patients |
Locations
1220 N Fant St
Anderson, SC 29621
Phone (803) 225-1139
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1131926400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1224028800000",
"number": "1477534782",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 838",
"city": "ANDERSON",
"state": "SC",
"postal_code": "296220838",
"telephone_number": "864-224-8707",
"fax_number": "894-225-1139"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1220 N FANT ST",
"city": "ANDERSON",
"state": "SC",
"postal_code": "296214822",
"telephone_number": "864-226-6005",
"fax_number": "864-225-1139"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PORTER",
"first_name": "DAVID",
"middle_name": "G",
"name_prefix": "Dr.",
"credential": "OPTOMETRIST",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-11-14",
"last_updated": "2008-10-15",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "SC",
"license": "642",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Anderson, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.