NPIMap

Organization Active NPI

Stuart P. Creson Inc

  • Optometrist
  • Surfside Beach, SC
National Provider Identifier
1659517175
Registry record updated Jan 6, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1218 Issued in SC
Legal business name
STUART P. CRESON INC
Practice address
2751 Beaver Run Blvd
Suite C
Surfside Beach, SC 29575
Phone
(843) 215-0101
Fax
(843) 215-0113
NPI assigned
Jan 6, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2009

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

Authorized official

Name
Stuart P Creson, ODNPI 1730110537
Title
Owner
Phone
(843) 215-0101

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
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 1218 SC Primary

Addresses

Primary practice location

2751 Beaver Run Blvd
Suite C
Surfside Beach, SC 29575

Mailing address

P O Box 30819
Myrtle Beach, SC 29588
Phone (843) 215-0101

Other identifiers 1

IdentifierTypeStateIssuer
D12190MedicaidSC

Other names 1

  • STUART P. CRESON INC Doing business as

National Provider Directory

National Provider Directory

Locations

2751 Beaver Run Blvd
Ste C
Surfside Beach, SC 29575
Phone (843) 215-0101

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1231200000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1231200000000",
    "number": "1659517175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P O BOX 30819",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "29588",
            "telephone_number": "843-215-0101",
            "fax_number": "843-215-0113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2751 BEAVER RUN BLVD",
            "address_2": "SUITE C",
            "city": "SURFSIDE BEACH",
            "state": "SC",
            "postal_code": "29575",
            "telephone_number": "843-215-0101",
            "fax_number": "843-215-0113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STUART P. CRESON INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-01-06",
        "last_updated": "2009-01-06",
        "status": "A",
        "authorized_official_last_name": "CRESON",
        "authorized_official_first_name": "STUART",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "843-215-0101",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "SC",
            "license": "1218",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "D12190",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "STUART P. CRESON INC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Surfside Beach, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2009; 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.