Individual provider Active NPI

Alice C Sun, O.D.

  • Optometrist
  • Charleston, SC
National Provider Identifier
1497869945
Registry record updated Dec 4, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1111 Issued in SC
Practice address
1231 Folly Rd
Charleston, SC 29412-4105
Phone
(873) 795-3400
Fax
(843) 795-3435
NPI assigned
Aug 19, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 4, 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 1111 SC Primary
Corneal and Contact Management Optometrist 152WC0802X 1111 SC

Addresses

Primary practice location

1231 Folly Rd
Charleston, SC 29412-4105

Mailing address

1231 Folly Rd
Charleston, SC 29412-4105
Phone (873) 795-3400

Other identifiers 7

IdentifierTypeStateIssuer
10403OtherSCSPECTERA
47104OtherSCDAVIS VISION
D6995OtherSCMEDCOST
571077813OtherSCSUPERIOR VISION
571077813OtherSCTHOMAS COOPER
D11111MedicaidSC
571077813OtherSCBCBS

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
I20070801000400 SC Practitioner - Optometry 2466543715 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pennsylvania College of Optometry, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dr. Alice C. Sun and Associates, PCGroup PAC ID 6002907359, 2 clinicians

Practice addresses (Care Compare)

1231 Folly Rd
Charleston, SC 29412-4105
Phone (843) 795-3400

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Dr. Alice C. Sun & Associates, PC Corneal and Contact Management CurrentSince Sep 5, 2006 Accepting new patients

Locations

1231 Folly Rd
Charleston, SC 29412
Phone (843) 762-9047

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1155945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196726400000",
    "number": "1497869945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1231 FOLLY RD",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294124105",
            "telephone_number": "873-795-3400",
            "fax_number": "843-795-3435"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1231 FOLLY RD",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294124105",
            "telephone_number": "873-795-3400",
            "fax_number": "843-795-3435"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUN",
        "first_name": "ALICE",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-19",
        "last_updated": "2007-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "SC",
            "license": "1111",
            "primary": true
        },
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "SC",
            "license": "1111",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SPECTERA",
            "identifier": "10403",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DAVIS VISION",
            "identifier": "47104",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDCOST",
            "identifier": "D6995",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SUPERIOR VISION",
            "identifier": "571077813",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "THOMAS COOPER",
            "identifier": "571077813",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "D11111",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "571077813",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, SC

Sources for this page

Verify at the official NPI Registry.