NPIMap

Organization Active NPI

Pee Dee Eye Associates PA

  • Optometrist
  • Hartsville, SC
National Provider Identifier
1508973462
Registry record updated Aug 26, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1422 Issued in SC
Legal business name
PEE DEE EYE ASSOCIATES PA
Practice address
504 S 4TH St
Hartsville, SC 29550-5720
Phone
(843) 332-7171
Fax
(843) 332-7802
NPI assigned
Aug 24, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2014

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

Authorized official

Name
Theodore W Newman, O.D.
Title
President
Phone
(843) 332-7171

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 1422 SC Primary

Addresses

Primary practice location

504 S 4TH St
Hartsville, SC 29550-5720

Mailing address

PO Box 1956
Hartsville, SC 29551-1956
Phone (843) 332-7171

Other identifiers 4

IdentifierTypeStateIssuer
DA9759MedicaidSC
D13340MedicaidSC
459665MedicaidSC
D14223MedicaidSC

National Provider Directory

National Provider Directory

Locations

602 E Main St
Bennettsville, SC 29512
Phone (843) 473-2020

505 S 4TH St
Hartsville, SC 29550

Practitioners & affiliated clinicians

Practitioners 8

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": "1156377600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1409011200000",
    "number": "1508973462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1956",
            "city": "HARTSVILLE",
            "state": "SC",
            "postal_code": "295511956",
            "telephone_number": "843-332-7171",
            "fax_number": "843-332-7802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "504 S 4TH ST",
            "city": "HARTSVILLE",
            "state": "SC",
            "postal_code": "295505720",
            "telephone_number": "843-332-7171",
            "fax_number": "843-332-7802"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEE DEE EYE ASSOCIATES PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-24",
        "last_updated": "2014-08-26",
        "status": "A",
        "authorized_official_last_name": "NEWMAN",
        "authorized_official_first_name": "THEODORE",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "843-332-7171",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "SC",
            "license": "1422",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "DA9759",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "D13340",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "459665",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "D14223",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hartsville, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2014; 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.