Eye Associates of Cayce West Columbia
Organization Active NPI Optometrist · Cayce, SC
NPI 1740353093 · NPPES record last updated Aug 22, 2020
Key facts
- NPI
- 1740353093
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Optometrist 152W00000X
- Legal business name
- EYE ASSOCIATES OF CAYCE WEST COLUMBIA
- Practice address
- 600 Knox Abbott Drive
Cayce, SC 29033-4127 - Phone
- (803) 794-4444
- Fax
- (803) 794-2085
- NPI assigned
- Nov 16, 2006
- Organization subpart
- No
Authorized official
- Name
- Dr. Julianne S Kleckley, OD
- Title
- Doctor Owner
- Phone
- (803) 794-4444
Practitioners 9
-
Janine Joy Henry, O.D.
-
Rufus Bedford Antley, O.D.
-
Jason C Lee, OD
-
Katherine Savas Mason, O.D.
-
John D Randall, OD
-
Crystal G. Whittington, O.D.
-
Joseph J Zinkovich, O.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in SC
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040504000252 | SC | Part B Supplier - Clinic/Group Practice | 5890783369 |
Receives reassigned benefits from 3 practitioners Practice locations: Cayce, SC |
National Provider Directory
Locations
606 Knox Abbott Dr
Cayce, SC 29033
Phone (803) 794-4444
606 Knox Abbott Dr
Cayce, SC 29033
Phone (803) 794-4444
314 Columbia Ave
Lexington, SC 29072
Phone (803) 359-2294
600 Knox Abbott Dr
West Columbia, SC 29033
Phone (803) 755-0213
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist |
152W00000X | Yes |
Addresses
Primary practice location
600 Knox Abbott Drive
Cayce, SC 29033-4127
Mailing address
600 Knox Abbott Drive
Cayce, SC 29033-4127
Phone (803) 794-4444
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0627220001 | Other | SC | DMERC |
| DA9984 | Medicaid | SC |
Other providers in Cayce, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 22, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.