NPIMap

Individual provider Active NPI

Nicole Walker, O.D.

  • Optometrist
  • Greer, SC
National Provider Identifier
1780656884
Registry record updated Oct 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1694 Issued in SC
Practice address
415 Brockman McClimon Rd
Greer, SC 29651
Phone
(864) 989-1432
Fax
(864) 896-8039
NPI assigned
Feb 2, 2006
Last updated
Oct 22, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1694 SC Primary
Optometrist 152W00000X TUV006935 NY

Addresses

Primary practice location

415 Brockman McClimon Rd
Greer, SC 29651

Mailing address

415 Brockman McClimon Rd
Greer, SC 29651-6608
Phone (864) 989-1432

Other practice location 1

41 Park Creek Dr
c/o GREENVILLE VA EYE CLINIC
Greenville, SC 29605-4270
Phone (864) 299-1600 ext. 2713

Other practice location 2

41 Park Creek Dr
c/o GREENVILLE VA EYE CLINIC
Greenville, SC 29605-4270
Phone (864) 299-1600 ext. 2713

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)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

LicenseStateTypeSpecialty
TUV006935NYMDOptometrist
1694SCMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Samuel Schenker OD, PC Optometrist PastSince Jan 1, 2005 Accepting new patients
Columbia Vamc PastSince Aug 2, 2020 Accepting new patients
State of New York Comptrollers Office Optometrist Past Accepting new patients
State of New York Comptrollers Office Past Accepting new patients

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1138838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571702400000",
    "number": "1780656884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 BROCKMAN MCCLIMON RD",
            "city": "GREER",
            "state": "SC",
            "postal_code": "296516608",
            "telephone_number": "864-989-1432"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 BROCKMAN MCCLIMON RD",
            "city": "GREER",
            "state": "SC",
            "postal_code": "29651",
            "telephone_number": "864-989-1432",
            "fax_number": "864-896-8039"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "41 Park Creek Dr",
            "address_2": "c/o GREENVILLE VA EYE CLINIC",
            "address_purpose": "LOCATION",
            "city": "Greenville",
            "state": "SC",
            "postal_code": "296054270",
            "country_code": "US",
            "telephone_number": "864-299-1600 x2713",
            "fax_number": "864-422-2965",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "41 Park Creek Dr",
            "address_2": "c/o GREENVILLE VA EYE CLINIC",
            "address_purpose": "LOCATION",
            "city": "Greenville",
            "state": "SC",
            "postal_code": "296054270",
            "country_code": "US",
            "telephone_number": "864-299-1600 x2713",
            "fax_number": "864-422-2965",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WALKER",
        "first_name": "NICOLE",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-02",
        "last_updated": "2019-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "SC",
            "license": "1694",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "TUV006935",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greer, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2019; 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.