Clemson Eye, PA

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

CLEMSON EYE, PA

Practice address

300 E Monroe St
Dillon, SC 29536-2560

Phone

(864) 654-6706

NPI assigned

Jul 20, 2020

Organization subpart

No

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

Authorized official

Name

Lanita Weisenberger

Title

Credentialing Specialist

Phone

(864) 722-1133

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1595203200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1595203200000",
    "number": "1669080305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 SOUTHERN CENTER CT",
            "city": "EASLEY",
            "state": "SC",
            "postal_code": "296421533",
            "telephone_number": "864-722-1133",
            "fax_number": "864-343-2074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 E MONROE ST",
            "city": "DILLON",
            "state": "SC",
            "postal_code": "295362560",
            "telephone_number": "864-654-6706"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLEMSON EYE, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-07-20",
        "last_updated": "2020-07-20",
        "certification_date": "2020-07-20",
        "status": "A",
        "authorized_official_last_name": "WEISENBERGER",
        "authorized_official_first_name": "LANITA",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "864-722-1133"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Comprehensive Dental Center of South Carolina

• All providers in Dillon, SC
• Optometrist in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2020; 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.