Organization Active NPI

Dr. E. M. Poole Jr. LLC

  • Optometrist
  • Spartanburg, SC
National Provider Identifier
1801983705
Registry record updated Aug 8, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
539 Issued in SC
Legal business name
DR. E. M. POOLE JR. LLC
Practice address
705 E Main St
Spartanburg, SC 29302-1281
Phone
(864) 585-3281
Fax
(864) 585-2255
NPI assigned
Oct 10, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2011

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

Authorized official

Name
Dr. Edgar Morgan Poole Jr., OD
Title
Managing Member
Phone
(864) 585-3281

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 539 SC Primary

Addresses

Primary practice location

705 E Main St
Spartanburg, SC 29302-1281

Mailing address

705 E Main St
Spartanburg, SC 29302-1281
Phone (864) 585-3281

Other identifiers 1

IdentifierTypeStateIssuer
D05395MedicaidSC

National Provider Directory

National Provider Directory

Locations

705 E Main St
Spartanburg, SC 29302
Phone (864) 585-3281

NPI Registry JSON

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

{
    "created_epoch": "1160438400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1312761600000",
    "number": "1801983705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "705 E MAIN ST",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "293021281",
            "telephone_number": "864-585-3281",
            "fax_number": "864-585-2255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "705 E MAIN ST",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "293021281",
            "telephone_number": "864-585-3281",
            "fax_number": "864-585-2255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. E. M. POOLE JR. LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-10",
        "last_updated": "2011-08-08",
        "status": "A",
        "authorized_official_last_name": "POOLE",
        "authorized_official_first_name": "EDGAR",
        "authorized_official_middle_name": "MORGAN",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "864-585-3281",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "SC",
            "license": "539",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "D05395",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Spartanburg, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2011; 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.