Organization Active NPI

Carolina Cataract Clinic

  • Ophthalmology Physician
  • Batesburg, SC
National Provider Identifier
1497930440
Registry record updated Jul 22, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
CAROLINA CATARACT CLINIC
Practice address
115 W Church St
Batesburg, SC 29006-2108
Phone
(803) 788-2276
Fax
(803) 788-1022
NPI assigned
Jan 8, 2008
Organization subpart
Yes
Parent organization
CAROLINA CATARACT CLINICAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 22, 2008

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

Authorized official

Name
Dean R Jacobs, M.D.NPI 1427034040
Title
Owner
Phone
(803) 788-2276

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207W00000X Primary

Addresses

Primary practice location

115 W Church St
Batesburg, SC 29006-2108

Mailing address

PO Box 23098
Columbia, SC 29224-3098
Phone (803) 788-2276

Other identifiers 1

IdentifierTypeStateIssuer
GP3390MedicaidSC

National Provider Directory

National Provider Directory
Tax ID family
Carolina Cataract Clinic4 organizations share this tax ID, including this one
Part of
Carolina Cataract Clinic

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Locations

115 W Church St
Batesburg, SC 29006
Phone (803) 788-2276

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1199750400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1216684800000",
    "number": "1497930440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 23098",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292243098",
            "telephone_number": "803-788-2276",
            "fax_number": "803-788-1022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 W CHURCH ST",
            "city": "BATESBURG",
            "state": "SC",
            "postal_code": "290062108",
            "telephone_number": "803-788-2276",
            "fax_number": "803-788-1022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAROLINA CATARACT CLINIC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CAROLINA CATARACT CLINIC",
        "enumeration_date": "2008-01-08",
        "last_updated": "2008-07-22",
        "status": "A",
        "authorized_official_last_name": "JACOBS",
        "authorized_official_first_name": "DEAN",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "803-788-2276",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP3390",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Batesburg, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2008; 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.