Organization Active NPI

Family Vision of Anderson PA

Doing business as Family Vision

  • Optometrist
  • Anderson, SC
National Provider Identifier
1629121165
Registry record updated Sep 29, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
824 Issued in SC
Legal business name
FAMILY VISION OF ANDERSON PA
Doing business as
Family Vision
Practice address
2808 E North Ave
Anderson, SC 29625-2300
Phone
(864) 226-6041
Fax
(864) 226-1232
NPI assigned
Jan 19, 2007
Last updated
Sep 29, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2017

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

Authorized official

Name
Dr. Randall I Baughman, O.D.NPI 1528021276
Title
Optometrist
Phone
(864) 226-6041

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 824 SC Primary

Addresses

Primary practice location

2808 E North Ave
Anderson, SC 29625-2300

Mailing address

2808 E North Ave
Anderson, SC 29625-2300
Phone (864) 226-6041

Other identifiers 1

IdentifierTypeStateIssuer
P00173470OtherSCRAILROAD MEDICARE

Other names 1

  • Family Vision Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20171002000132 SC Part B Supplier - Clinic/Group Practice 8224303227 Receives reassigned benefits from 7 practitioners
Practice locations: Anderson, SC; Clemson, SC; Williamston, SC

National Provider Directory

National Provider Directory

Locations

2808 E North Ave
Anderson, SC 29625
Phone (864) 226-6041

518 College Ave
Clemson, SC 29631
Phone (864) 226-6041

900A Greenville Dr
Williamston, SC 29697
Phone (864) 847-7657

Practitioners & affiliated clinicians

Practitioners 9

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": "1169164800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1506643200000",
    "number": "1629121165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2808 E NORTH AVE",
            "city": "ANDERSON",
            "state": "SC",
            "postal_code": "296252300",
            "telephone_number": "864-226-6041",
            "fax_number": "864-226-1232"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2808 E NORTH AVE",
            "city": "ANDERSON",
            "state": "SC",
            "postal_code": "296252300",
            "telephone_number": "864-226-6041",
            "fax_number": "864-226-1232"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY VISION OF ANDERSON PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-19",
        "last_updated": "2017-09-29",
        "status": "A",
        "authorized_official_last_name": "BAUGHMAN",
        "authorized_official_first_name": "RANDALL",
        "authorized_official_middle_name": "I",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "864-226-6041",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "SC",
            "license": "824",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00173470",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Family Vision",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Anderson, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2017; 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.