Kimberly Dawn Stoneburner, LICENSED OPTICIAN
Individual provider Active NPI Optician · Ridgeville, SC
NPI 1497718555 · NPPES record last updated Feb 8, 2011
Key facts
- NPI
- 1497718555
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Optician 156FX1800X
- License
- 717 (SC)
- Practice address
- 447 South Railroad Ave.
Ridgeville, SC 29472 - Phone
- (843) 452-4140
- Fax
- (843) 688-4192
- NPI assigned
- Apr 10, 2006
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 717 | SC | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Plantation Eyecare | Optician | Current | Accepting new patients |
| KD Optical | Optician | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optician | 156FX1800X | 717 | SC | Yes |
Addresses
Primary practice location
447 South Railroad Ave.
Ridgeville, SC 29472
Mailing address
742 Nancys PL
Ridgeville, SC 29472-7000
Phone (843) 452-4140
Other names
- Ms. Kimberly Dawn Moore
Other providers in Ridgeville, SC
- Refreshed Total Wellness
- Elizabeth Anne Ringold
- S&G Smiles Ride Service LLC
- Nefateri Smalls
- Lashonda Yvette Smith
- Tanyetta Felder Thompson
- Ervena Washington
All providers in Ridgeville, SC · Optician in South Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 8, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.