Individual provider Active NPI

Adriane E Banks, O.D.

  • Optometrist
  • North Charleston, SC
National Provider Identifier
1578583159
Registry record updated Nov 14, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1316 Issued in SC
Practice address
4920 Centre Pointe Drive
North Charleston, SC 29418-6927
Phone
(843) 529-0280
Fax
(843) 529-0380
NPI assigned
Jul 19, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 14, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1316 SC Primary

Addresses

Primary practice location

4920 Centre Pointe Drive
North Charleston, SC 29418-6927

Mailing address

PO Box 1473
Johns Island, SC 29457-1473
Phone (843) 766-1093

Other identifiers 1

IdentifierTypeStateIssuer
D13162MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
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 1

Enrollment IDStateProvider typePAC IDDetails
I20070808000015 SC Practitioner - Optometry 0042301988 Practice locations: North Charleston, SC

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1316SCMDOptometrist

NPI Registry JSON

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

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1226620800000",
    "number": "1578583159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1473",
            "city": "JOHNS ISLAND",
            "state": "SC",
            "postal_code": "294571473",
            "telephone_number": "843-766-1093",
            "fax_number": "843-529-0380"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4920 CENTRE POINTE DRIVE",
            "city": "NORTH CHARLESTON",
            "state": "SC",
            "postal_code": "294186927",
            "telephone_number": "843-529-0280",
            "fax_number": "843-529-0380"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANKS",
        "first_name": "ADRIANE",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-19",
        "last_updated": "2008-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "SC",
            "license": "1316",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "D13162",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in North Charleston, SC

Sources for this page

Verify at the official NPI Registry.