The Vision Center at Seaside Farms

Primary specialty

OptometristTaxonomy code 152W00000X

License

1461 Issued in SC

Legal business name

THE VISION CENTER AT SEASIDE FARMS

Practice address

1296 Long Grove Dr
Mount Pleasant, SC 29464-9462

Phone

(843) 388-6200

Fax

(888) 224-4732

NPI assigned

May 8, 2009

Last updated

Aug 17, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

David Bradley Bodkin, O.D.NPI 1295875938

Title

President

Phone

(843) 388-6200

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in SC

Enrollment records 1

Locations

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• David Bradley Bodkin, O.D.

  • Optometrist
  • Mount Pleasant, SC
  • NPI 1295875938
  Medicare reassignment Care Compare group NPD Authorized official
• Karyssa Huynh Davis, O.D.

  • Optometrist
  • Charleston, SC
  • NPI 1710662440
  Medicare reassignment Care Compare group NPD
• Bobi Yang, OD

  • Optometrist
  • Salisbury, NC
  • NPI 1295556538

  SC

  Medicare reassignment Care Compare group NPD
• Savannah Coker, OD

  • Optometrist
  • Mount Pleasant, SC
  • NPI 1710501267
  Medicare reassignment NPD
• Aprile Doubt, OD

  • Optometrist
  • Mount Pleasant, SC
  • NPI 1659059152
  Medicare reassignment NPD
• Jesse Michael Willingham, OD

  • Optometrist
  • North Charleston, SC
  • NPI 1588157291
  Medicare reassignment NPD
• Jill Alexis Yates, OD

  • Optometrist
  • Mount Pleasant, SC
  • NPI 1578496469
  NPD

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

{
    "created_epoch": "1241740800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1597622400000",
    "number": "1710111588",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1296 LONG GROVE DR",
            "city": "MOUNT PLEASANT",
            "state": "SC",
            "postal_code": "294649462",
            "telephone_number": "843-388-6200",
            "fax_number": "888-224-4732"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1296 LONG GROVE DR",
            "city": "MOUNT PLEASANT",
            "state": "SC",
            "postal_code": "294649462",
            "telephone_number": "843-388-6200",
            "fax_number": "888-224-4732"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE VISION CENTER AT SEASIDE FARMS",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-05-08",
        "last_updated": "2020-08-17",
        "certification_date": "2020-08-17",
        "status": "A",
        "authorized_official_last_name": "BODKIN",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "BRADLEY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "843-388-6200",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "SC",
            "license": "1461",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Optometrist in Mount Pleasant, SC
• Providers in Mount Pleasant, SC by specialty
• Optometrist in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2020; 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.