Individual provider Active NPI

Phillip Meredith, O.D.

  • Optometrist
  • Myrtle Beach, SC
National Provider Identifier
1740256841
Registry record updated Sep 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1028 Issued in SC
Practice address
1651 Glenns Bay Rd
Myrtle Beach, SC 29575-4836
Phone
(843) 650-2400
Fax
(843) 699-2227
NPI assigned
Feb 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1028 SC Primary

Addresses

Primary practice location

1651 Glenns Bay Rd
Myrtle Beach, SC 29575-4836

Mailing address

1651 Glenns Bay Rd
Myrtle Beach, SC 29575-4836
Phone (843) 650-2400

Other identifiers 1

IdentifierTypeStateIssuer
D10281MedicaidSC

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
I20050330000044 SC Practitioner - Optometry 5496701740 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Indiana University - School of Optometry, 1994
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

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1028SCMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
East Coast Optometric, Inc Optometrist Past Accepting new patients
F Mason Smith Optometrist Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1140998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726617600000",
    "number": "1740256841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1651 GLENNS BAY RD",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295754836",
            "telephone_number": "843-650-2400",
            "fax_number": "843-699-2227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1651 GLENNS BAY RD",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295754836",
            "telephone_number": "843-650-2400",
            "fax_number": "843-699-2227"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEREDITH",
        "first_name": "PHILLIP",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-27",
        "last_updated": "2024-09-18",
        "certification_date": "2024-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "SC",
            "license": "1028",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "D10281",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Myrtle Beach, SC

Sources for this page

Verify at the official NPI Registry.