Eyecare Specialties of Charleston

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

EYECARE SPECIALTIES OF CHARLESTON

Practice address

3531 Mary Ader Ave Ste B
Charleston, SC 29414-5896

Phone

(843) 577-2047

NPI assigned

Dec 28, 2005

Organization subpart

No

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

Authorized official

Name

Kim Faulkner

Title

Administrator

Phone

(843) 577-2047

Specialties & licenses 2

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1135728000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1556755200000",
    "number": "1487631867",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3531 MARY ADER AVE STE B",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294145896",
            "telephone_number": "843-577-2047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3531 MARY ADER AVE STE B",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294145896",
            "telephone_number": "843-577-2047"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "112 Bull St",
            "address_purpose": "LOCATION",
            "city": "Charleston",
            "state": "SC",
            "postal_code": "294011713",
            "country_code": "US",
            "telephone_number": "843-577-2047",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "EYECARE SPECIALTIES OF CHARLESTON",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-28",
        "last_updated": "2019-05-02",
        "status": "A",
        "authorized_official_last_name": "FAULKNER",
        "authorized_official_first_name": "KIM",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "843-577-2047"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "DA9789",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Eye Care Specialties Group - West Ashley
• Eye Center of Charleston
• Eye on Eyes
• Eyecare Optical LLC
• Eyecare Physicians & Surgeons LLC
• Kristin D Eyre, LMSW
• Nnadozie Ezerioha, MD
• Lorianne T Ezman, MD
• Heather Nicole Fabel, FNP-C
• Katherine Geneva Fabrizio, APRN-C

• Optometrist in Charleston, SC
• Providers in Charleston, SC by specialty
• Optometrist in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2019; 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.