Individual provider Active NPI

Jake Pray, OD

  • Optometrist
  • Walhalla, SC
National Provider Identifier
1508392465
Registry record updated Jun 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2399 Issued in SC
Practice address
105 N Earle St
Walhalla, SC 29691-2419
Phone
(864) 638-9505
Fax
(864) 638-9979
NPI assigned
May 11, 2017
Last updated
Jun 5, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2399 SC Primary

Addresses

Primary practice location

105 N Earle St
Walhalla, SC 29691-2419

Mailing address

105 N Earle St
Walhalla, SC 29691-2419
Phone (864) 638-9505

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI, SC2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20170713002215 WI Practitioner - Optometry 1052680642 Reassigns benefits to 2 organizations
I20241001004555 SC Practitioner - Optometry 1052680642 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of Houston - College of Optometry, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Scott W Nebel OD LLCGroup PAC ID 7416366273, 2 clinicians
Family Vision of Anderson PAGroup PAC ID 8224303227, 6 clinicians

Practice addresses (Care Compare)

105 N Earle St
Walhalla, SC 29691-2419
Phone (864) 638-9505

2808 E N Ave
Anderson, SC 29625-2300
Phone (864) 226-6041

Merit-based Incentive Payment System (MIPS)

Final score
99.73 of 100Reported as group
Quality
99.46
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Family Vision PC Optometrist CurrentSince Aug 13, 2024 Accepting new patients
Memorial Medical Center Inc CurrentSince Jul 1, 2020 Accepting new patients
Advanced Family Eyecare Optometrist CurrentSince Sep 8, 2020 Accepting new patients
Family Vision of Anderson PA Optometrist CurrentSince Aug 13, 2024 Accepting new patients
Memorial Medical Center Inc CurrentSince Jul 1, 2020 Accepting new patients
Scott W Nebel OD LLC Optometrist CurrentSince May 15, 2025 Accepting new patients

Locations

2808 E North Ave
Anderson, SC 29625
Phone (864) 226-6041

518 College Ave
Clemson, SC 29631
Phone (864) 226-6041

105 N Earle St
Walhalla, SC 29691
Phone (864) 638-9505

900A Greenville Dr
Williamston, SC 29697
Phone (864) 847-7657

1615 Maple Ln
Ashland, WI 54806
Phone (715) 682-4563

308 W Fulton St
Waupaca, WI 54981
Phone (715) 258-8168

Interoperability endpoints

  • Direct secure messaging: jake.pray@direct.revolutionehr.com

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1494460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780617600000",
    "number": "1508392465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 N EARLE ST",
            "city": "WALHALLA",
            "state": "SC",
            "postal_code": "296912419",
            "telephone_number": "864-638-9505",
            "fax_number": "864-638-9979"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 N EARLE ST",
            "city": "WALHALLA",
            "state": "SC",
            "postal_code": "296912419",
            "telephone_number": "864-638-9505",
            "fax_number": "864-638-9979"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRAY",
        "first_name": "JAKE",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-05-11",
        "last_updated": "2026-06-05",
        "certification_date": "2026-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "SC",
            "license": "2399",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Walhalla, SC

Sources for this page

Verify at the official NPI Registry.