Individual provider Active NPI

Jessica Marie Palmer, OD

  • Optometrist
  • Summerville, SC
National Provider Identifier
1629762117
Registry record updated Jun 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2404 Issued in SC
Practice address
717 Old Trolley Rd Ste 3
Summerville, SC 29485-5287
Phone
(843) 873-1889
Fax
(843) 873-1663
NPI assigned
Jun 7, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2404 SC Primary

Addresses

Primary practice location

717 Old Trolley Rd Ste 3
Summerville, SC 29485-5287

Mailing address

717 Old Trolley Rd Ste 3
Summerville, SC 29485-5287
Phone (843) 873-1889

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
I20230623001562 SC Practitioner - Optometry 0941668958 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Indiana University - School of Optometry, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Eye Care Associates of SC LLCGroup PAC ID 4587998802, 63 clinicians

Practice addresses (Care Compare)

966 Houston Northcutt Blvd
Suite D
Mount Pleasant, SC 29464-3487
Phone (843) 881-2492

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2404SCMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Eye Care Associates of SC LLC Optometrist CurrentSince Jul 8, 2025 Accepting new patients
F Mason Smith Optometrist PastSince Jul 8, 2025 Accepting new patients

Locations

1903 N Highway 17
Ste 100
Mt Pleasant, SC 29464
Phone (843) 216-1338

966 Houston Northcutt Blvd
Ste D
Mt Pleasant, SC 29464
Phone (843) 881-2492

8409 Dorchester Rd
Ste 105
North Charleston, SC 29420
Phone (843) 619-7234

2007 2nd Ave
Ste A
Summerville, SC 29486
Phone (843) 873-1889

717 Trolley Rd
Ste 3
Summerville, SC 29485
Phone (843) 873-1889

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1686096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686096000000",
    "number": "1629762117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "717 OLD TROLLEY RD STE 3",
            "city": "SUMMERVILLE",
            "state": "SC",
            "postal_code": "294855287",
            "telephone_number": "843-873-1889",
            "fax_number": "843-873-1663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "717 OLD TROLLEY RD STE 3",
            "city": "SUMMERVILLE",
            "state": "SC",
            "postal_code": "294855287",
            "telephone_number": "843-873-1889",
            "fax_number": "843-873-1663"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PALMER",
        "first_name": "JESSICA",
        "middle_name": "MARIE",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-07",
        "last_updated": "2023-06-07",
        "certification_date": "2023-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "SC",
            "license": "2404",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Summerville, SC

Sources for this page

Verify at the official NPI Registry.