Organization Active NPI

Donelson Eye Associates

  • Ophthalmology Physician
  • Greenville, SC
National Provider Identifier
1508058959
Registry record updated Jun 29, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
10906 Issued in SC
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

Updated by the provider on Jun 29, 2011

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)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207W00000X
Ophthalmology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 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

IdentifierTypeStateIssuer
109064MedicaidSC
PC4223MedicaidSC

Other names 1

  • Piedmont Eye Associates Former legal business name

National Provider Directory

National Provider Directory

Locations

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.

Verify at the official NPI Registry.