NPIMap

Organization Active NPI

Southeastern Vision Institute LLC

  • Ophthalmology Physician
  • Mount Pleasant, SC
National Provider Identifier
1679014138
Registry record updated Mar 17, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
MD32317 Issued in SC
Legal business name
SOUTHEASTERN VISION INSTITUTE LLC
Practice address
735 Johnnie Dodds Blvd
101
Mount Pleasant, SC 29464-3058
Phone
(843) 216-2020
NPI assigned
Mar 17, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2017

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

Authorized official

Name
William Waring IV, MD
Title
Owner
Phone
(843) 216-2020

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207W00000X MD32317 SC Primary

Addresses

Primary practice location

735 Johnnie Dodds Blvd
101
Mount Pleasant, SC 29464-3058

Mailing address

735 Johnnie Dodds Blvd
101
Mount Pleasant, SC 29464-3058
Phone (843) 216-2020

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170519000006 SC Part B Supplier - Clinic/Group Practice 6709153950 Receives reassigned benefits from 5 practitioners
Practice locations: Mount Pleasant, SC

National Provider Directory

National Provider Directory

Locations

735 Johnnie Dodds Blvd
Ste 101
Mt Pleasant, SC 29464
Phone (843) 216-2020

Practitioners & affiliated clinicians

Practitioners 5

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": "1489708800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1489708800000",
    "number": "1679014138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "735 JOHNNIE DODDS BLVD",
            "address_2": "101",
            "city": "MOUNT PLEASANT",
            "state": "SC",
            "postal_code": "294643058",
            "telephone_number": "843-216-2020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "735 JOHNNIE DODDS BLVD",
            "address_2": "101",
            "city": "MOUNT PLEASANT",
            "state": "SC",
            "postal_code": "294643058",
            "telephone_number": "843-216-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHEASTERN VISION INSTITUTE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-17",
        "last_updated": "2017-03-17",
        "status": "A",
        "authorized_official_last_name": "WARING",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "843-216-2020",
        "authorized_official_name_suffix": "IV",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "SC",
            "license": "MD32317",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Pleasant, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2017; 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.