Angel Oak Eye Center

Primary specialty

OptometristTaxonomy code 152W00000X

License

907 Issued in SC

Legal business name

ANGEL OAK EYE CENTER

Practice address

2875 Maybank Hwy
Johns Island, SC 29455-4808

Phone

(843) 559-5333

Fax

(843) 559-5339

NPI assigned

Dec 8, 2006

Last updated

Oct 27, 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

Paul W Bohac, O.D.

Title

Owner

Phone

(843) 559-5333

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in SC

Enrollment records 1

Locations

Practitioners 1

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.

• Emily Doran Rettew, OD

  • Optometrist
  • Columbia, SC
  • NPI 1700469772
  Medicare reassignment NPD

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

{
    "created_epoch": "1165536000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1225065600000",
    "number": "1548329097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 874",
            "city": "JOHNS ISLAND",
            "state": "SC",
            "postal_code": "294570874",
            "telephone_number": "843-559-5333",
            "fax_number": "843-559-5339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2875 MAYBANK HWY",
            "city": "JOHNS ISLAND",
            "state": "SC",
            "postal_code": "294554808",
            "telephone_number": "843-559-5333",
            "fax_number": "843-559-5339"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANGEL OAK EYE CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-08",
        "last_updated": "2008-10-27",
        "status": "A",
        "authorized_official_last_name": "BOHAC",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "843-559-5333",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "SC",
            "license": "907",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "DO9070",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "DA9762",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cheryl Ann Allen, APRN
• James Crawford Allen, M.D.
• Alpha Home Care LLC
• Natalie Altieri, MA, LPC
• Rebekah Gould Anderson, DMD
• Angel Oak Family Medicine LLC
• Angel Oak Pediatrics LLC
• Anthony C Ross
• Bradley Paul Anuszkiewicz
• Kimberly A Arza, RN

• Optometrist in Johns Island, SC
• Providers in Johns Island, SC by specialty
• Optometrist in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 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.