NPIMap

Organization Active NPI

Columbia Eye Clinic PA

  • Clinic/Center
  • Columbia, SC
National Provider Identifier
1720044514
Registry record updated Aug 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
COLUMBIA EYE CLINIC PA
Practice address
1920 Pickens St
Columbia, SC 29201
Phone
(803) 779-3070
Fax
(803) 771-7639
NPI assigned
Apr 21, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2020

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

Authorized official

Name
Langston Spotts
Title
Ceo
Phone
(803) 779-3070

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X Primary

Addresses

Primary practice location

1920 Pickens St
Columbia, SC 29201

Mailing address

PO Box 60371
Charlotte, NC 28260-0371
Phone (803) 779-3070

Other identifiers 1

IdentifierTypeStateIssuer
PA0187MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20060515000010 SC Part B Supplier - Clinic/Group Practice 8426069907 Receives reassigned benefits from 26 practitioners
Practice locations: Columbia, SC; Lexington, SC; West Columbia, SC
O20100930031405 SC DME Supplier - Physician - OphthalmologyDME Supplier - Optician 8426069907 Practice locations: Columbia, SC

National Provider Directory

National Provider Directory
Tax ID family
Columbia Eye Clinic PA6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

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

Locations

3227 Sunset Blvd
Ste C
West Columbia, SC 29169
Phone (803) 779-3070

Practitioners & affiliated clinicians

Practitioners 29

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

View all 29

NPI Registry JSON

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

{
    "created_epoch": "1145577600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1597622400000",
    "number": "1720044514",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60371",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282600371",
            "telephone_number": "803-779-3070",
            "fax_number": "803-771-7639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1920 PICKENS ST",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "29201",
            "telephone_number": "803-779-3070",
            "fax_number": "803-771-7639"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLUMBIA EYE CLINIC PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-21",
        "last_updated": "2020-08-17",
        "certification_date": "2020-08-17",
        "status": "A",
        "authorized_official_last_name": "SPOTTS",
        "authorized_official_first_name": "LANGSTON",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "803-779-3070"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PA0187",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, SC

Sources for this page

  • 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.