Tidewater Eyecare, LLC

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

TIDEWATER EYECARE, LLC

Practice address

301 Front St.
Summerville, SC 29486

Phone

(843) 261-2020

Fax

(843) 261-2080

NPI assigned

Dec 4, 2019

Organization subpart

No

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

Authorized official

Name

Jeffrey Hood, ODNPI 1871621797

Title

Owner

Phone

(843) 754-2798

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in SC

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jeffrey Hood, OD

  • Optometrist
  • Mount Pleasant, SC
  • NPI 1871621797
  Medicare reassignment NPD Authorized official
• Sherry J Gilmer, O.D.

  • Optometrist
  • Greenville, SC
  • NPI 1831262435
  NPD (past)

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

{
    "created_epoch": "1575417600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1575417600000",
    "number": "1750928164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 CHARLESTON BLVD",
            "city": "ISLE OF PALMS",
            "state": "SC",
            "postal_code": "294512122",
            "telephone_number": "843-754-2798",
            "fax_number": "843-261-2080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 FRONT ST.",
            "city": "SUMMERVILLE",
            "state": "SC",
            "postal_code": "29486",
            "telephone_number": "843-261-2020",
            "fax_number": "843-261-2080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TIDEWATER EYECARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-12-04",
        "last_updated": "2019-12-04",
        "status": "A",
        "authorized_official_last_name": "HOOD",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "843-754-2798",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Henry C Thompson II, ED.S.
• Ryan Thompson
• Carinne Shelley Thorne, FNP
• Thrivewell Home Care LLC
• Tidewater Dentistry, PA
• Terri L Tierney, PT.CWS
• Mary Kate Tillman, M.D.
• Tina Greene & Associates, LLC
• Dustin Tincher, PHARMD
• Harley Ann-Renee Tisdale

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.