Individual provider Active NPI

Jason Thomason, OD

  • Optometrist
  • Moncks Corner, SC
National Provider Identifier
1760080824
Registry record updated Oct 12, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2232 Issued in SC
Practice address
113 Foxbank Plantation Blvd # C
Moncks Corner, SC 29461-6707
Phone
(843) 761-6485
NPI assigned
Oct 12, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2232 SC Primary

Addresses

Primary practice location

113 Foxbank Plantation Blvd # C
Moncks Corner, SC 29461-6707

Mailing address

102 Brick Park LN
Goose Creek, SC 29445-7349
Phone (205) 913-3721

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1602460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602460800000",
    "number": "1760080824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 BRICK PARK LN",
            "city": "GOOSE CREEK",
            "state": "SC",
            "postal_code": "294457349",
            "telephone_number": "205-913-3721"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "113 FOXBANK PLANTATION BLVD # C",
            "city": "MONCKS CORNER",
            "state": "SC",
            "postal_code": "294616707",
            "telephone_number": "843-761-6485"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMASON",
        "first_name": "JASON",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-10-12",
        "last_updated": "2020-10-12",
        "certification_date": "2020-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "SC",
            "license": "2232",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Moncks Corner, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.