Alva S Pack III PA

Primary specialty

OptometristTaxonomy code 152W00000X

License

489 Issued in SC

Legal business name

ALVA S PACK III PA

Practice address

399 E Henry St
Spartanburg, SC 29302-2639

Phone

(864) 585-0208

Fax

(864) 594-6783

NPI assigned

Jul 27, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Louis Ligon Martin IV, ODNPI 1922063940

Title

Optometrist/Owner

Phone

(864) 585-0208

Specialties & licenses 1

Addresses

Other identifiers 2

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.

• Louis Ligon Martin IV, OD

  • Optometrist
  • Spartanburg, SC
  • NPI 1922063940
  Medicare reassignment Care Compare group NPD Authorized official
• Lara J Martin, O.D.

  • Optometrist
  • Spartanburg, SC
  • NPI 1518074392
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1153958400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1370476800000",
    "number": "1780608463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "399 E HENRY ST",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "293022639",
            "telephone_number": "864-585-0208",
            "fax_number": "864-594-6783"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "399 E HENRY ST",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "293022639",
            "telephone_number": "864-585-0208",
            "fax_number": "864-594-6783"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALVA S PACK III PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-27",
        "last_updated": "2013-06-06",
        "status": "A",
        "authorized_official_last_name": "MARTIN",
        "authorized_official_first_name": "LOUIS",
        "authorized_official_middle_name": "LIGON",
        "authorized_official_title_or_position": "OPTOMETRIST/OWNER",
        "authorized_official_telephone_number": "864-585-0208",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "IV",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "SC",
            "license": "489",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1922063940",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1407811573",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Allergy Partners, PLLC
• Rebecca S Allison, LPC
• Thomas Frederick Allred, MD
• Madhavi Allu, M.D.
• Tamieka Latrell Alston-Gibson, FNP
• Rebecca Rechell Alvarez, LPN
• Isaac Edward Alwine, M.D.
• Octavia Amaechi, MD
• Prince Keside Amaechi, M.D.
• Amb Healthtips & House Calls Inc

• All providers in Spartanburg, SC
• Optometrist in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2013; 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.