Individual provider Active NPI

Sidney F. Thomas, OD

  • Optometrist
  • Orangeburg, SC
National Provider Identifier
1477697548
Registry record updated Aug 1, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
984 Issued in SC
Practice address
915 John C Calhoun Dr
Orangeburg, SC 29115-6763
Phone
(803) 536-3755
Fax
(803) 536-2584
NPI assigned
Feb 20, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 1, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 984 SC Primary

Addresses

Primary practice location

915 John C Calhoun Dr
Orangeburg, SC 29115-6763

Mailing address

PO Box 30201
Charleston, SC 29417
Phone (803) 536-3755

Other identifiers 1

IdentifierTypeStateIssuer
DA9845MedicaidSC

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040806000674 SC Practitioner - Optometry 6507838984 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

915 John C Calhoun Dr
Orangeburg, SC 29115-6763
Phone (803) 536-3755

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Sidney F Thomas PA Optometrist CurrentSince Jul 1, 2004 Accepting new patients
Low Country Eye Care Inc Optometrist Past Accepting new patients
Avondale Eye Care Optometrist Past Accepting new patients
Carolina Eyes Past Accepting new patients

Locations

915 John C Calhoun Dr
Orangeburg, SC 29115
Phone (803) 536-3755

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1171929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1375315200000",
    "number": "1477697548",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 30201",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "29417",
            "telephone_number": "803-536-3755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "915 JOHN C CALHOUN DR",
            "city": "ORANGEBURG",
            "state": "SC",
            "postal_code": "291156763",
            "telephone_number": "803-536-3755",
            "fax_number": "803-536-2584"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "SIDNEY",
        "middle_name": "F.",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-20",
        "last_updated": "2013-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "SC",
            "license": "984",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "DA9845",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orangeburg, SC

Sources for this page

Verify at the official NPI Registry.