Individual provider Active NPI

Kathleen Diane Juliano, OD

  • Optometrist
  • Travelers Rest, SC
National Provider Identifier
1477671865
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1116 Issued in SC
Practice address
9 Benton Rd
Travelers Rest, SC 29690
Phone
(864) 834-3111
Fax
(864) 834-0567
NPI assigned
Mar 26, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1116 SC Primary
Optometrist 152W00000X 1928 NC

Addresses

Primary practice location

9 Benton Rd
Travelers Rest, SC 29690

Mailing address

9 Benton Rd
Travelers Rest, SC 29690
Phone (864) 834-3111

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.
Opted out of Medicare
Previously, effective Aug 10, 2016 through Aug 10, 2026

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
1928NCMDChiropractor

Organizations & group practices 1

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": "1174867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1477671865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9 BENTON RD",
            "city": "TRAVELERS REST",
            "state": "SC",
            "postal_code": "29690",
            "telephone_number": "864-834-3111",
            "fax_number": "864-834-0567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9 BENTON RD",
            "city": "TRAVELERS REST",
            "state": "SC",
            "postal_code": "29690",
            "telephone_number": "864-834-3111",
            "fax_number": "864-834-0567"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JULIANO",
        "first_name": "KATHLEEN",
        "middle_name": "DIANE",
        "name_prefix": "Mrs.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "SC",
            "license": "1116",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NC",
            "license": "1928",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Travelers Rest, SC

Sources for this page

Verify at the official NPI Registry.