Plaxico Eye Care, LLC.

Primary specialty

OptometristTaxonomy code 152W00000X

License

1412 Issued in SC

Legal business name

PLAXICO EYE CARE, LLC.

Practice address

749B University Village Dr
Blythewood, SC 29016-7613

Phone

(803) 714-1116

Fax

(803) 714-1116

NPI assigned

Aug 18, 2009

Organization subpart

No

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

Authorized official

Name

Dr. Brent E. Plaxico, O.D.

Title

Optometrist

Phone

(803) 714-1116

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1250553600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1354665600000",
    "number": "1578795902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "135I BLYTHEWOOD RD",
            "city": "BLYTHEWOOD",
            "state": "SC",
            "postal_code": "290168426",
            "telephone_number": "803-714-1116",
            "fax_number": "803-714-1116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "749B UNIVERSITY VILLAGE DR",
            "city": "BLYTHEWOOD",
            "state": "SC",
            "postal_code": "290167613",
            "telephone_number": "803-714-1116",
            "fax_number": "803-714-1116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PLAXICO EYE CARE, LLC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-08-18",
        "last_updated": "2012-12-05",
        "status": "A",
        "authorized_official_last_name": "PLAXICO",
        "authorized_official_first_name": "BRENT",
        "authorized_official_middle_name": "E.",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "803-714-1116",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "SC",
            "license": "1412",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "D14125",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Optometrist in Blythewood, SC
• Providers in Blythewood, SC by specialty
• Optometrist in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2012; 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.