Samantha P Rodriguez, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

1961 Issued in SC

Practice address

1 Colony Centre Way
Simpsonville, SC 29681-3286

Phone

(864) 458-3900

Fax

(864) 967-9118

NPI assigned

May 4, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

Practice roles

Locations

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

• Jervey Eye Group, PA

  • Ophthalmology Physician
  • Simpsonville, SC
  • NPI 1447220710

  Optometrist

  Medicare reassignment NPD
• Jervey Eye Group, PA

  • Ophthalmology Physician
  • Easley, SC
  • NPI 1700856077

  Optometrist

  NPD
• Jervey Eye Group, PA

  • Ophthalmology Physician
  • Greenville, SC
  • NPI 1992775696

  Optometrist

  NPD

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

{
    "created_epoch": "1336089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694131200000",
    "number": "1659630176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 HALTON RD",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296073403",
            "telephone_number": "864-458-7956",
            "fax_number": "864-458-8390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 COLONY CENTRE WAY",
            "city": "SIMPSONVILLE",
            "state": "SC",
            "postal_code": "296813286",
            "telephone_number": "864-458-3900",
            "fax_number": "864-967-9118"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "601 Halton Rd",
            "address_purpose": "LOCATION",
            "city": "Greenville",
            "state": "SC",
            "postal_code": "296073403",
            "country_code": "US",
            "telephone_number": "864-458-7956",
            "fax_number": "864-458-8390",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "SAMANTHA",
        "middle_name": "P",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-05-04",
        "last_updated": "2023-09-08",
        "certification_date": "2023-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "SC",
            "license": "1961",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rachel Annette Robinson, FNP-BC
• William Graham Robinson, FNP
• Lita Robison, DC
• Rock Bottom Renewal, LLC
• Bradyn Edward Roddy
• Laura Roe
• Todd A Roemmich, M.D.
• Nina J Rogers
• Rolfe Psychiatric Care LLC
• Raymond V Romano, D.O.

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.