NPIMap

Organization Active NPI

Palmetto Eye Specialists-Optometrists

  • Optometrist
  • Hilton Head, SC
National Provider Identifier
1689831521
Registry record updated May 19, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1462 Issued in SC
Legal business name
PALMETTO EYE SPECIALISTS-OPTOMETRISTS
Practice address
220 Pembroke Dr
Hilton Head, SC 29926-6200
Phone
(843) 785-5398
Fax
(843) 785-5394
NPI assigned
May 19, 2008
Organization subpart
Yes
Parent organization
PALMETTO EYE SPECIALISTS, PAAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 19, 2008

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

Authorized official

Name
Emily C Bollin, OD
Title
Optometrist
Phone
(843) 785-5398

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 1462 SC Primary

Addresses

Primary practice location

220 Pembroke Dr
Hilton Head, SC 29926-6200

Mailing address

220 Pembroke Dr
Hilton Head, SC 29926-6200
Phone (843) 785-5398

Other identifiers 3

IdentifierTypeStateIssuer
D13326MedicaidSC
D14624MedicaidSC
GP2666MedicaidSC

National Provider Directory

National Provider Directory
Tax ID family
Sungate Dermatology3 organizations share this tax ID, including this one
Part of
Sungate Dermatology

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1211155200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1211155200000",
    "number": "1689831521",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 PEMBROKE DR",
            "city": "HILTON HEAD",
            "state": "SC",
            "postal_code": "299266200",
            "telephone_number": "843-785-5398",
            "fax_number": "843-785-5394"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 PEMBROKE DR",
            "city": "HILTON HEAD",
            "state": "SC",
            "postal_code": "299266200",
            "telephone_number": "843-785-5398",
            "fax_number": "843-785-5394"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PALMETTO EYE SPECIALISTS-OPTOMETRISTS",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PALMETTO EYE SPECIALISTS, PA",
        "enumeration_date": "2008-05-19",
        "last_updated": "2008-05-19",
        "status": "A",
        "authorized_official_last_name": "BOLLIN",
        "authorized_official_first_name": "EMILY",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "843-785-5398",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "SC",
            "license": "1462",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "D13326",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "D14624",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP2666",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hilton Head, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2008; 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.