Active NPI
Donelson Eye Associates
- Ophthalmology Physician
- Greenville, SC
National Provider Identifier
1508058959
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ophthalmology Physician
- License
- 10906
- Legal business name
- DONELSON EYE ASSOCIATES
- Practice address
- 1 Halton Green Way
Greenville, SC 29607-6606 - Phone
- (864) 987-0034
- Fax
- (864) 987-0036
- NPI assigned
- Aug 9, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. David M Donelson, MD
- Title
- President
- Phone
- (864) 987-0034
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ophthalmology Physician | 207W00000X | |||
| Ophthalmology Physician | 207W00000X | 10906 | SC | Primary |
Addresses
Primary practice location
1 Halton Green Way
Greenville, SC 29607-6606
Mailing address
PO Box 27169
Greenville, SC 29616-7169
Phone (864) 987-0034
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 109064 | Medicaid | SC | |
| PC4223 | Medicaid | SC |
Other names 1
- Piedmont Eye Associates
National Provider Directory
National Provider DirectoryLocations
205 Enterprise Blvd
Ste 150
Greenville, SC 29615
Phone (864) 987-0034
200 Patewood Dr
Ste A150
Greenville, SC 29615
Phone (864) 987-0034
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1186617600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1309305600000",
"number": "1508058959",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 27169",
"city": "GREENVILLE",
"state": "SC",
"postal_code": "296167169",
"telephone_number": "864-987-0034",
"fax_number": "864-987-0036"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 HALTON GREEN WAY",
"city": "GREENVILLE",
"state": "SC",
"postal_code": "296076606",
"telephone_number": "864-987-0034",
"fax_number": "864-987-0036"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "DONELSON EYE ASSOCIATES",
"organizational_subpart": "NO",
"enumeration_date": "2007-08-09",
"last_updated": "2011-06-29",
"status": "A",
"authorized_official_last_name": "DONELSON",
"authorized_official_first_name": "DAVID",
"authorized_official_middle_name": "M",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "864-987-0034",
"authorized_official_name_prefix": "Mr.",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "207W00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Ophthalmology",
"state": null,
"license": null,
"primary": false
},
{
"code": "207W00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Ophthalmology",
"state": "SC",
"license": "10906",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "109064",
"state": "SC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "PC4223",
"state": "SC"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Piedmont Eye Associates",
"code": "4",
"type": "Former Legal Business Name"
}
]
}
Other providers in Greenville, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.