Individual provider Active NPI

Chad A Carlsson, OD

  • Optometrist
  • Loris, SC
National Provider Identifier
1508853904
Registry record updated Sep 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2242 Issued in SC
Practice address
3911 Main St
Loris, SC 29569-3017
Phone
(864) 654-6706
Fax
(843) 756-6667
NPI assigned
Sep 30, 2005
Last updated
Sep 10, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 10, 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 2242 SC Primary

Addresses

Primary practice location

3911 Main St
Loris, SC 29569-3017

Mailing address

PO Box 11407
Birmingham, AL 35246-8575
Phone (864) 359-1308

Other practice location 1

1003 Prince St
Georgetown, SC 29440-3551
Phone (843) 543-6333

Other practice location 2

2614 E Highway 76
Marion, SC 29571-6840
Phone (864) 654-6706

Other practice location 3

380 W Wesmark Blvd
Sumter, SC 29150-1977
Phone (864) 654-6706

Other practice location 4

400 N Cashua Dr
Florence, SC 29501-2098
Phone (864) 654-6706

Other practice location 5

710 Hopewell Dr Ste 106
Charleston, SC 29492-7108
Phone (843) 543-6333

Other identifiers 1

IdentifierTypeStateIssuer
11555337OtherCAQH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY, 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
I20180831001544 KY Practitioner - Optometry 8628047339 Reassigns benefits to 1 organization
I20210128002856 SC Practitioner - Optometry 8628047339 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Clemson Eye PAGroup PAC ID 4183537764, 51 clinicians

Practice addresses (Care Compare)

3911 Main St
Loris, SC 29569-3017
Phone (864) 654-6706

710 Hopewell Dr
Suite 106
Charleston, SC 29492-7108
Phone (843) 543-6333

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1350AZMDProfessional Counselor
2242SCMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
My Eyewear Optometrist Current Accepting new patients
Look of South Carolina PA Optometrist CurrentSince Aug 30, 2022 Accepting new patients
Clemson Eye, PA Optometrist CurrentSince May 1, 2026 Accepting new patients
Coastal Eye Group, P.C. CurrentSince Dec 21, 2025 Accepting new patients
Dawn C Stratton OD PSC Optometrist CurrentSince Sep 1, 2018 Accepting new patients
Coastal Eye Group, P.C. CurrentSince Dec 21, 2025 Accepting new patients
F Mason Smith Optometrist Past Accepting new patients
Clemson Eye, PA Optometrist PastSince May 1, 2026 Accepting new patients

Locations

535 Wellington Way
Ste 160
Lexington, KY 40503
Phone (859) 245-2020

710 Hopewell Dr
Ste 106
Charleston, SC 29492
Phone (480) 580-6671

400 N Cashua Dr
Florence, SC 29501
Phone (843) 664-9398

1003 Prince St
Georgetown, SC 29440
Phone (843) 543-6333

1200 Highmarket St
Georgetown, SC 29440
Phone (843) 546-8421

3911 Main St
Loris, SC 29569
Phone (843) 756-1262

4055 Highway 17
Murrells Inlt, SC 29576
Phone (843) 652-3937

380 W Wesmark Blvd
Sumter, SC 29150

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 8

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": "1128038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788998400000",
    "number": "1508853904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 11407",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352468575",
            "telephone_number": "864-359-1308",
            "fax_number": "239-496-3939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3911 MAIN ST",
            "city": "LORIS",
            "state": "SC",
            "postal_code": "295693017",
            "telephone_number": "864-654-6706",
            "fax_number": "843-756-6667"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1003 Prince St",
            "address_purpose": "LOCATION",
            "city": "Georgetown",
            "state": "SC",
            "postal_code": "294403551",
            "country_code": "US",
            "telephone_number": "843-543-6333",
            "fax_number": "843-543-6332",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2614 E Highway 76",
            "address_purpose": "LOCATION",
            "city": "Marion",
            "state": "SC",
            "postal_code": "295716840",
            "country_code": "US",
            "telephone_number": "864-654-6706",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "380 W Wesmark Blvd",
            "address_purpose": "LOCATION",
            "city": "Sumter",
            "state": "SC",
            "postal_code": "291501977",
            "country_code": "US",
            "telephone_number": "864-654-6706",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "400 N Cashua Dr",
            "address_purpose": "LOCATION",
            "city": "Florence",
            "state": "SC",
            "postal_code": "295012098",
            "country_code": "US",
            "telephone_number": "864-654-6706",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "710 Hopewell Dr Ste 106",
            "address_purpose": "LOCATION",
            "city": "Charleston",
            "state": "SC",
            "postal_code": "294927108",
            "country_code": "US",
            "telephone_number": "843-543-6333",
            "fax_number": "843-543-6332",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CARLSSON",
        "first_name": "CHAD",
        "middle_name": "A",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-30",
        "last_updated": "2026-09-10",
        "certification_date": "2026-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "SC",
            "license": "2242",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "11555337",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Loris, SC

Sources for this page

Verify at the official NPI Registry.