NPIMap

Organization Active NPI

Lancaster Eye Clinic P.a.

Doing business as The Eye and Laser Center

  • Ophthalmology Physician
  • Lancaster, SC
National Provider Identifier
1730140625
Registry record updated Jun 29, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
LANCASTER EYE CLINIC P.A.
Doing business as
The Eye and Laser Center
Practice address
1240 Colonial Commons CT
Lancaster, SC 29720-2200
Phone
(803) 285-4333
Fax
(803) 285-3472
NPI assigned
Mar 30, 2006
Last updated
Jun 29, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2010

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

Authorized official

Name
Mrs. Krystal A Ware
Title
Agencies Coordinator
Phone
(803) 475-2132

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207W00000X Primary

Addresses

Primary practice location

1240 Colonial Commons CT
Lancaster, SC 29720-2200

Mailing address

1240 Colonial Commons CT
Lancaster, SC 29720-2200
Phone (803) 285-4333

Other identifiers 1

IdentifierTypeStateIssuer
PA3870MedicaidSC

Other names 1

  • The Eye and Laser Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20101105000182 SC Part B Supplier - Clinic/Group Practice 4981799509 Receives reassigned benefits from 8 practitioners
Practice locations: Lancaster, SC; Indian Land, SC; Chester, SC

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
42D2106855The Eye and Laser Center1240 Colonial Commons, Lancaster, SC 29720Certificate of waiverDec 29, 2027

National Provider Directory

National Provider Directory

Locations

1 Medical Park Dr
Ofc 1
Chester, SC 29706
Phone (803) 285-4333

1240 Colonial Commons Ct
Lancaster, SC 29720
Phone (803) 285-3333

Practitioners & affiliated clinicians

Practitioners 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1143676800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1277769600000",
    "number": "1730140625",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1240 COLONIAL COMMONS CT",
            "city": "LANCASTER",
            "state": "SC",
            "postal_code": "297202200",
            "telephone_number": "803-285-4333",
            "fax_number": "803-285-3472"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1240 COLONIAL COMMONS CT",
            "city": "LANCASTER",
            "state": "SC",
            "postal_code": "297202200",
            "telephone_number": "803-285-4333",
            "fax_number": "803-285-3472"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LANCASTER EYE CLINIC P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-30",
        "last_updated": "2010-06-29",
        "status": "A",
        "authorized_official_last_name": "WARE",
        "authorized_official_first_name": "KRYSTAL",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "AGENCIES COORDINATOR",
        "authorized_official_telephone_number": "803-475-2132",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PA3870",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Eye and Laser Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lancaster, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.