NPIMap

Organization Active NPI

Lowcountry Eye Care of Cane Bay, LLC

  • Optometrist
  • Summerville, SC
National Provider Identifier
1700319282
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1365 Issued in SC
Legal business name
LOWCOUNTRY EYE CARE OF CANE BAY, LLC
Practice address
1718 State Rd # 176
Suite 3 (8D)
Summerville, SC 29486-2801
Phone
(843) 797-1264
Fax
(843) 764-3206
NPI assigned
Apr 11, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Dr. Francis W Shealy III, O.D.NPI 1891780508
Title
Partner
Phone
(843) 797-1264

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 1365 SC Primary

Addresses

Primary practice location

1718 State Rd # 176
Suite 3 (8D)
Summerville, SC 29486-2801

Mailing address

425 Red Bank Rd
Goose Creek, SC 29445-4505
Phone (843) 797-1264

Other names 1

  • Lowcountry Eye Care Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170920000192 SC Part B Supplier - Clinic/Group Practice 3779857412 Receives reassigned benefits from 14 practitioners
Practice locations: Summerville, SC

National Provider Directory

National Provider Directory

Locations

102 Greenland Dr
Goose Creek, SC 29445
Phone (843) 203-6551

1718 State Rd
Ste 7C
Summerville, SC 29486

Practitioners & affiliated clinicians

Practitioners 15

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1491868800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1700319282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "425 RED BANK RD",
            "city": "GOOSE CREEK",
            "state": "SC",
            "postal_code": "294454505",
            "telephone_number": "843-797-1264",
            "fax_number": "843-764-3602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1718 STATE RD # 176",
            "address_2": "SUITE 3 (8D)",
            "city": "SUMMERVILLE",
            "state": "SC",
            "postal_code": "294862801",
            "telephone_number": "843-797-1264",
            "fax_number": "843-764-3206"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOWCOUNTRY EYE CARE OF CANE BAY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-11",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "SHEALY",
        "authorized_official_first_name": "FRANCIS",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "843-797-1264",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "SC",
            "license": "1365",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lowcountry Eye Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Summerville, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.