Individual provider Active NPI

Amy Melissa Suffolk

  • Optician
  • Rock Hill, SC
National Provider Identifier
1669232690
Registry record updated Mar 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OpticianTaxonomy code 156FX1800X
License
OP1117A
Practice address
2377 Dave Lyle Blvd
Rock Hill, SC 29730-7939
Phone
(803) 366-9404
Fax
(803) 366-0251
NPI assigned
Mar 19, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 19, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optician 156FX1800X OP1117A Primary

Addresses

Primary practice location

2377 Dave Lyle Blvd
Rock Hill, SC 29730-7939

Mailing address

2377 Dave Lyle Blvd
Rock Hill, SC 29730-7939
Phone (803) 366-9404

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1710806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710806400000",
    "number": "1669232690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2377 DAVE LYLE BLVD",
            "city": "ROCK HILL",
            "state": "SC",
            "postal_code": "297307939",
            "telephone_number": "803-366-9404",
            "fax_number": "803-366-0251"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2377 DAVE LYLE BLVD",
            "city": "ROCK HILL",
            "state": "SC",
            "postal_code": "297307939",
            "telephone_number": "803-366-9404",
            "fax_number": "803-366-0251"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUFFOLK",
        "first_name": "AMY",
        "middle_name": "MELISSA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-03-19",
        "last_updated": "2024-03-19",
        "certification_date": "2024-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Optician",
            "state": null,
            "license": "OP1117A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rock Hill, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2024; 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.