Fort Mill Optical Inc

Primary specialty

OptometristTaxonomy code 152W00000X

License

1387 Issued in SC

Legal business name

FORT MILL OPTICAL INC

Doing business as

Fort Mill Vision Center

Practice address

1090 Spratt St
Fort Mill, SC 29715-8226

Phone

(803) 547-5547

Fax

(803) 547-5724

NPI assigned

Jun 9, 2006

Last updated

Apr 1, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Deborah A Long, O.D.NPI 1710968326

Title

Optometrist/Owner

Phone

(803) 547-5547

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Fort Mill Vision Center Doing business as

Medicare fee-for-service enrollment

Enrolled in SC

Enrollment records 1

Locations

Practitioners 5

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.

• Adam Richard Dutson, O.D.

  • Optometrist
  • Fort Mill, SC
  • NPI 1942638697
  Medicare reassignment Care Compare group NPD
• Allyson Thomas Spratt, O.D.

  • Optometrist
  • Fort Mill, SC
  • NPI 1669852190
  Medicare reassignment Care Compare group NPD
• Deborah A. Long, OD

  • Optometrist
  • Fort Mill, SC
  • NPI 1710968326
  Authorized official Same address or phone
• Melissa Schwebach Wood, OD

  • Optometrist
  • Rock Hill, SC
  • NPI 1417948175
  NPD (past)
• Susan F Blake, OD

  • Optometrist
  • Massillon, OH
  • NPI 1811963705
  NPD (past)

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

{
    "created_epoch": "1149811200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1207008000000",
    "number": "1548201908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1149",
            "city": "FORT MILL",
            "state": "SC",
            "postal_code": "297161149",
            "telephone_number": "803-547-5547",
            "fax_number": "803-547-5724"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1090 SPRATT ST",
            "city": "FORT MILL",
            "state": "SC",
            "postal_code": "297158226",
            "telephone_number": "803-547-5547",
            "fax_number": "803-547-5724"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FORT MILL OPTICAL INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-09",
        "last_updated": "2008-04-01",
        "status": "A",
        "authorized_official_last_name": "LONG",
        "authorized_official_first_name": "DEBORAH",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OPTOMETRIST/OWNER",
        "authorized_official_telephone_number": "803-547-5547",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "SC",
            "license": "1387",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "DA9735",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Fort Mill Vision Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Fort Mill Chiropractic Health Center, P.a.
• Fort Mill Dermatology, LLC
• Fort Mill Dobys Bridge Dental LLC (Fort Mill Dental)
• Fort Mill Home Care
• Fort Mill Neurology, LLC
• Fort Mill Pharmacy
• Fort Mill Rescue Squad
• Fort Mill School District #4
• Fort Mill Smiles Dentistry, PC (Fort Mill Smiles Dentistry)
• Fort Mill Spine and Sports Rehab, LLC

• Optometrist in Fort Mill, SC
• Providers in Fort Mill, SC by specialty
• Optometrist in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2008; 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.