Individual provider Active NPI

Jerd Watts Poston, O.D.

  • Optometrist
  • Surfside Beach, SC
National Provider Identifier
1720080971
Registry record updated Jan 2, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
694 Issued in SC
Practice address
1651 Glenns Bay Rd
Surfside Beach, SC 29575-4836
Phone
(843) 650-2400
Fax
(843) 650-2525
NPI assigned
Jun 1, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 2, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 694 SC Primary

Addresses

Primary practice location

1651 Glenns Bay Rd
Surfside Beach, SC 29575-4836

Mailing address

PO Box 15790
Surfside Beach, SC 29587-5790
Phone (843) 650-2400

Other identifiers 1

IdentifierTypeStateIssuer
DO6946MedicaidSC

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
I20120105001011 SC Practitioner - Optometry 2062433550 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Eye Care Associates of SC LLCGroup PAC ID 4587998802, 63 clinicians

Practice addresses (Care Compare)

966 Houston Northcutt Blvd
Suite D
Mount Pleasant, SC 29464-3487
Phone (843) 881-2492

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
694SCMDOptometrist
696SCMDOptometrist
6946SCMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
F Mason Smith Optometrist Past Accepting new patients
Coastal Vision Center Optometrist Past Accepting new patients
Andrews Vision Center Optometrist Past Accepting new patients

Organizations & group practices 4

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

NPI Registry JSON

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

{
    "created_epoch": "1117584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1199232000000",
    "number": "1720080971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 15790",
            "city": "SURFSIDE BEACH",
            "state": "SC",
            "postal_code": "295875790",
            "telephone_number": "843-650-2400",
            "fax_number": "843-650-2525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1651 GLENNS BAY RD",
            "city": "SURFSIDE BEACH",
            "state": "SC",
            "postal_code": "295754836",
            "telephone_number": "843-650-2400",
            "fax_number": "843-650-2525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POSTON",
        "first_name": "JERD",
        "middle_name": "WATTS",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-01",
        "last_updated": "2008-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "SC",
            "license": "694",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "DO6946",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Surfside Beach, SC

Sources for this page

Verify at the official NPI Registry.