NPIMap

Organization Active NPI

Aiken Ophthalmology PC

  • Clinic/Center
  • Aiken, SC
National Provider Identifier
1659315802
Registry record updated Aug 20, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
License
21946 Issued in SC
Legal business name
AIKEN OPHTHALMOLOGY PC
Doing business as
Aiken Ophthalmology PC
Practice address
110 Pepper Hill Way
Aiken, SC 29801-2818
Phone
(803) 642-6060
Fax
(803) 642-0754
NPI assigned
Jun 16, 2006
Last updated
Aug 20, 2013By the provider in NPPES
Organization subpart
Yes
Parent organization
AIKEN OPHTHALMOLOGY PCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 20, 2013

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

Authorized official

Name
Mrs. Denise L Krok, COE, ST
Title
Administrator
Phone
(803) 642-6060

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X 21946 SC Primary

Addresses

Primary practice location

110 Pepper Hill Way
Aiken, SC 29801-2818

Mailing address

110 Pepper Hill Way
Aiken, SC 29801-2818
Phone (803) 642-6060

Other identifiers 2

IdentifierTypeStateIssuer
GP2963MedicaidSC
CH7684OtherSCRAILROAD MEDICARE

Other names 1

  • AIKEN OPHTHALMOLOGY PC Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041011000337 SC Part B Supplier - Clinic/Group Practice 6103885587 Receives reassigned benefits from 7 practitioners
Practice locations: Aiken, SC; Wagener, SC; North Augusta, SC; Batesburg, SC; Columbia, SC

National Provider Directory

National Provider Directory
Part of
Aiken Ophthalomology

Locations

410 University Pkwy
Ste 1560
Aiken, SC 29801
Phone (803) 641-6911

100 Ridge Medical Plaza Rd
Edgefield, SC 29824
Phone (803) 637-3630

536 W Martintown Rd
North Augusta, SC 29841
Phone (803) 510-0007

Practitioners & affiliated clinicians

Practitioners 11

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": "1150416000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1376956800000",
    "number": "1659315802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 PEPPER HILL WAY",
            "city": "AIKEN",
            "state": "SC",
            "postal_code": "298012818",
            "telephone_number": "803-642-6060",
            "fax_number": "803-642-0754"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 PEPPER HILL WAY",
            "city": "AIKEN",
            "state": "SC",
            "postal_code": "298012818",
            "telephone_number": "803-642-6060",
            "fax_number": "803-642-0754"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AIKEN OPHTHALMOLOGY PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "AIKEN OPHTHALMOLOGY PC",
        "enumeration_date": "2006-06-16",
        "last_updated": "2013-08-20",
        "status": "A",
        "authorized_official_last_name": "KROK",
        "authorized_official_first_name": "DENISE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "803-642-6060",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "COE, ST"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "SC",
            "license": "21946",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP2963",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CH7684",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "AIKEN OPHTHALMOLOGY PC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Aiken, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2013; 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.