Individual provider Active NPI

Chelsea Jade Branscum, OD

  • Optometrist
  • Simpsonville, SC
National Provider Identifier
1497446835
Registry record updated Jan 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2401 Issued in SC
Practice address
3950 Grandview Dr
Simpsonville, SC 29680-3163
Phone
(864) 963-6168
NPI assigned
May 17, 2023
Last updated
Jan 16, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2401 SC Primary

Addresses

Primary practice location

3950 Grandview Dr
Simpsonville, SC 29680-3163

Mailing address

3950 Grandview Dr
Simpsonville, SC 29680-3163
Phone (864) 963-6168

Other practice location 1

3950 Grandview Dr
Simpsonville, SC 29680-3163
Phone (864) 963-6168

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
I20240403001370 SC Practitioner - Optometry 3173961653 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2022
Medicare assignment
May accept Medicare assignment
Group practices
Branscum VisionGroup PAC ID 2264870740, 2 clinicians

Practice addresses (Care Compare)

3950 Grandview Dr
Suite 700
Simpsonville, SC 29680-3163
Phone (864) 963-4218

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2401SCMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Branscum Vision Optometrist CurrentSince Feb 28, 2024 Accepting new patients

Locations

3950 Grandview Dr
Simpsonville, SC 29680
Phone (864) 963-0272

3950 Grandview Dr
#700
Simpsonville, SC 29680
Phone (864) 963-4218

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": "1684281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705363200000",
    "number": "1497446835",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3950 GRANDVIEW DR",
            "city": "SIMPSONVILLE",
            "state": "SC",
            "postal_code": "296803163",
            "telephone_number": "864-963-6168"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3950 GRANDVIEW DR",
            "city": "SIMPSONVILLE",
            "state": "SC",
            "postal_code": "296803163",
            "telephone_number": "864-963-6168"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3950 Grandview Dr",
            "address_purpose": "LOCATION",
            "city": "Simpsonville",
            "state": "SC",
            "postal_code": "296803163",
            "country_code": "US",
            "telephone_number": "864-963-6168",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRANSCUM",
        "first_name": "CHELSEA",
        "middle_name": "JADE",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-17",
        "last_updated": "2024-01-16",
        "certification_date": "2024-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "SC",
            "license": "2401",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Simpsonville, SC

Sources for this page

Verify at the official NPI Registry.