Individual provider Active NPI

Kara Plank

  • Optometrist
  • Georgetown, SC
National Provider Identifier
1700361805
Registry record updated Jun 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OEG003483 Issued in PA
Practice address
1310 N Fraser St
Georgetown, SC 29440-2800
Phone
(843) 546-8946
NPI assigned
Sep 25, 2018
Last updated
Jun 10, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OEG003483 PA Primary

Addresses

Primary practice location

1310 N Fraser St
Georgetown, SC 29440-2800

Mailing address

223 Southgate CT
Pawleys Island, SC 29585-4407
Phone (215) 516-9206

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240617002706 SC Practitioner - Optometry 9436692696

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
New England College of Optometry, 2018
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

2672 David H McLeod Blvd
Florence, SC 29501-4042

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2164SCMDDentist
OEG003483PAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Bergelt Optometric LLC Optometrist CurrentSince May 15, 2024 Accepting new patients

Locations

2672 David H McLeod Blvd
Florence, SC 29501
Phone (843) 773-2758

1310 N Fraser St
#700
Georgetown, SC 29440
Phone (843) 546-8946

1334 N Fraser St
Georgetown, SC 29440
Phone (843) 932-2225

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1537833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717977600000",
    "number": "1700361805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "223 SOUTHGATE CT",
            "city": "PAWLEYS ISLAND",
            "state": "SC",
            "postal_code": "295854407",
            "telephone_number": "215-516-9206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1310 N FRASER ST",
            "city": "GEORGETOWN",
            "state": "SC",
            "postal_code": "294402800",
            "telephone_number": "843-546-8946"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PLANK",
        "first_name": "KARA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-25",
        "last_updated": "2024-06-10",
        "certification_date": "2024-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PA",
            "license": "OEG003483",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Georgetown, SC

Sources for this page

Verify at the official NPI Registry.