Individual provider Active NPI

Adia Jani McDuffey, O.D.

  • Optometrist
  • Summerville, SC
National Provider Identifier
1710876354
Registry record updated Sep 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2567 Issued in SC
Practice address
622 Bacons Bridge Rd Ste B
Summerville, SC 29485-4225
Phone
(843) 594-0919
NPI assigned
Jun 30, 2025
Last updated
Sep 8, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2567 SC Primary

Addresses

Primary practice location

622 Bacons Bridge Rd Ste B
Summerville, SC 29485-4225

Mailing address

8614 Westwood Center Dr FL 9
Vienna, VA 22182-2442
Phone (703) 847-8899

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
I20251015000910 SC Practitioner - Optometry 1153818927 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
International American University at Puerto Rico - School of Optometry, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1268 Ebenezer Rd
Rock Hill, SC 29732-2341
Phone (803) 327-2001

2601 N Main St
Suite E
Summerville, SC 29486-8981
Phone (843) 502-7705

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2567SCMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Myeyedr Optometry of South Carolina, LLC Optometrist CurrentSince Sep 15, 2025 Accepting new patients
Myeyedr Optometry of South Carolina, LLC Optometrist Current Accepting new patients
Myeyedr Optometry of South Carolina, LLC Optometrist CurrentSince Sep 15, 2025 Accepting new patients

Locations

88 Folly Road Blvd
Charleston, SC 29407
Phone (843) 573-9944

1774 Paxville Hwy
Manning, SC 29102
Phone (803) 435-2494

7643 Rivers Ave
Ste D
North Charleston, SC 29406
Phone (843) 797-0731

1268 Ebenezer Rd
Rock Hill, SC 29732
Phone (803) 327-2001

2601 N Main St
Ste E
Summerville, SC 29486
Phone (843) 502-7705

622 Bacons Bridge Rd
Ste B
Summerville, SC 29485
Phone (843) 594-0919

8614 Westwood Center Dr
Fl 9
Vienna, VA 22182

Organizations & group practices 3

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": "1751241600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757289600000",
    "number": "1710876354",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8614 WESTWOOD CENTER DR FL 9",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221822442",
            "telephone_number": "703-847-8899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "622 BACONS BRIDGE RD STE B",
            "city": "SUMMERVILLE",
            "state": "SC",
            "postal_code": "294854225",
            "telephone_number": "843-594-0919"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCDUFFEY",
        "first_name": "ADIA",
        "middle_name": "JANI",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-06-30",
        "last_updated": "2025-09-08",
        "certification_date": "2025-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "SC",
            "license": "2567",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Summerville, SC

Sources for this page

Verify at the official NPI Registry.