NPIMap

Organization Active NPI

Vital Eyes LLC

  • Optometrist
  • Chapin, SC
National Provider Identifier
1528848405
Registry record updated Sep 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
VITAL EYES LLC
Practice address
223 Columbia Ave
Ste B
Chapin, SC 29036
Phone
(803) 930-0036
Fax
(833) 722-0272
NPI assigned
Sep 29, 2023
Last updated
Sep 17, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2024

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

Authorized official

Name
Dr. Elisabeth J Lawson, ODNPI 1033422449
Title
Co-Owner
Phone
(803) 930-0036

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X NU Primary
Corneal and Contact Management Optometrist 152WC0802X NU
Pediatric Optometrist 152WP0200X NU

Addresses

Primary practice location

223 Columbia Ave
Ste B
Chapin, SC 29036

Mailing address

PO Box 496
Ballentine, SC 29002-0496

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240415003904 SC Part B Supplier - Clinic/Group Practice 8729427398 Receives reassigned benefits from 3 practitioners
Practice locations: Chapin, SC; Lexington, SC

National Provider Directory

National Provider Directory

Locations

223 Columbia Ave
#B
Chapin, SC 29036
Phone (803) 930-0036

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1695945600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1726531200000",
    "number": "1528848405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 496",
            "city": "BALLENTINE",
            "state": "SC",
            "postal_code": "290020496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "223 COLUMBIA AVE",
            "address_2": "STE B",
            "city": "CHAPIN",
            "state": "SC",
            "postal_code": "29036",
            "telephone_number": "803-930-0036",
            "fax_number": "833-722-0272"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VITAL EYES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-09-29",
        "last_updated": "2024-09-17",
        "certification_date": "2024-09-17",
        "status": "A",
        "authorized_official_last_name": "LAWSON",
        "authorized_official_first_name": "ELISABETH",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "803-930-0036",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "152WP0200X",
            "taxonomy_group": "",
            "desc": "Optometrist, Pediatrics",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chapin, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.