Individual provider Active NPI

Symber Serrano, LDO, ABOC, NCLEC

  • Optician
  • Greenville, SC
National Provider Identifier
1790417517
Registry record updated Jun 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OpticianTaxonomy code 156FX1800X
License
1116 Issued in SC
Practice address
6134 White Horse Rd
Greenville, SC 29611-3837
Phone
(864) 295-0412
Fax
(864) 295-0419
NPI assigned
Jun 29, 2022
Last updated
Jun 29, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optician 156FX1800X 1116 SC Primary

Addresses

Primary practice location

6134 White Horse Rd
Greenville, SC 29611-3837

Mailing address

206 Winston St
Pendleton, SC 29670-1234
Phone (864) 295-0412

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

NPI Registry JSON

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

{
    "created_epoch": "1656460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656460800000",
    "number": "1790417517",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "206 WINSTON ST",
            "city": "PENDLETON",
            "state": "SC",
            "postal_code": "296701234",
            "telephone_number": "864-295-0412",
            "fax_number": "864-295-0419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6134 WHITE HORSE RD",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296113837",
            "telephone_number": "864-295-0412",
            "fax_number": "864-295-0419"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SERRANO",
        "first_name": "SYMBER",
        "credential": "LDO, ABOC, NCLEC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-29",
        "last_updated": "2022-06-29",
        "certification_date": "2022-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Optician",
            "state": "SC",
            "license": "1116",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2022; 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.