Lawrence Raymond Custer, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

SC1237 Issued in SC

Practice address

1512 Coastal Grand Cir
C330
Myrtle Beach, SC 29577-0015

Phone

(843) 444-0090

Fax

(843) 444-0377

NPI assigned

Apr 17, 2007

Last updated

Feb 28, 2008By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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

• Coastal Grand Eye Associates LTD. Co.

  • Optometrist
  • Myrtle Beach, SC
  • NPI 1780728824
  Authorized official Same address or phone
• Coastal Eye Associates

  • Optometrist
  • Myrtle Beach, SC
  • NPI 1548830011
  NPD
• Erie Eye Associates LTD

  dba Broad View Eye Center

  • Optometrist
  • Broadview Heights, OH
  • NPI 1447239181
  NPD (past)

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

{
    "created_epoch": "1176768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1204156800000",
    "number": "1740406214",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 50864",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295790015",
            "telephone_number": "843-444-0090",
            "fax_number": "843-444-0377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1512 COASTAL GRAND CIR",
            "address_2": "C330",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295770015",
            "telephone_number": "843-444-0090",
            "fax_number": "843-444-0377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUSTER",
        "first_name": "LAWRENCE",
        "middle_name": "RAYMOND",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-17",
        "last_updated": "2008-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "SC",
            "license": "SC1237",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EYEMED VISION CARE",
            "identifier": "SC1237",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Daniel Joseph Edward Cunningham, MD
• Savannah Cunningham, PHARMD
• Melissa Jo-Ann Cupid, M.D
• Curo Health Services, LLC (Heartland Hospice (Myrtle Beach))
• Jessica Curtiss, PA-S
• Caroline Marie Cutler, MD
• Jessica Cvinar, MD
• CVS
• CVS Pharmacy
• CVS Pharmacy

• Optometrist in Myrtle Beach, SC
• Providers in Myrtle Beach, SC by specialty
• Optometrist in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.