Justine Siegers Petty, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

1603 Issued in SC

Practice address

121 Lucy LN
Columbia, SC 29229-7835

Phone

(803) 217-2550

Fax

(803) 217-2548

NPI assigned

Jul 13, 2010

Last updated

Jan 29, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Dr. Justine Marie Siegers Former name

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

Specialty

Optometry

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Aeg South Carolina Professional PCGroup PAC ID 5597129064, 16 clinicians

Practice addresses (Care Compare)

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.

• Aeg South Carolina Professional PC

  • Optometrist
  • Columbia, SC
  • NPI 1720768427
  Medicare reassignment Care Compare group NPD
• Carolina Forest Family Eyecare, P.a.

  • Optometrist
  • Myrtle Beach, SC
  • NPI 1972621423
  NPD (past)
• Sansbury Eye Center

  • Optician
  • Lexington, SC
  • NPI 1902927031
  NPD (past)
• Sansbury Vision Services LLC

  • Optometrist
  • Lexington, SC
  • NPI 1346776036
  NPD (past)

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

{
    "created_epoch": "1278979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738108800000",
    "number": "1740592237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1107",
            "city": "IRMO",
            "state": "SC",
            "postal_code": "29063",
            "telephone_number": "803-781-2123",
            "fax_number": "803-749-0183"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 LUCY LN",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292297835",
            "telephone_number": "803-217-2550",
            "fax_number": "803-217-2548"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETTY",
        "first_name": "JUSTINE",
        "middle_name": "SIEGERS",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-07-13",
        "last_updated": "2025-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "SC",
            "license": "SC1603",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "SC",
            "license": "1603",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JUSTINE",
            "last_name": "SIEGERS",
            "middle_name": "MARIE",
            "prefix": "DR.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Janet Petrino
• China Petteway, RBT
• Jerrell Pettigrew
• Sterling R Pettit Chancley
• Ashton Petty
• Gillian Pezzuti
• Christian Pham
• Mai-Trinh Truong Pham, MD
• Huong T Phan, MD
• Nathaniel Troy Pharis, DHSC, LPCS, LACS

• Optometrist in Columbia, SC
• Providers in Columbia, SC by specialty
• Optometrist in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2025; 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.
• 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.