Active NPI
Carolina Cataract Clinic
- Ophthalmology Physician
- Wagener, SC
National Provider Identifier
1811173602
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ophthalmology Physician
- Legal business name
- CAROLINA CATARACT CLINIC
- Practice address
- 149 North Main Street
Wagener, SC 29164 - Phone
- (803) 788-2276
- Fax
- (803) 788-1022
- NPI assigned
- Jan 11, 2008
- Last updated
- Jan 22, 2008
- Organization subpart
- Yes
- Parent organization
- CAROLINA CATARACT CLINIC
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dean R Jacobs, M.D.
- Title
- Owner
- Phone
- (803) 788-2276
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ophthalmology Physician | 207W00000X | NU | Primary |
Addresses
Primary practice location
149 North Main Street
Wagener, SC 29164
Mailing address
PO Box 23098
Columbia, SC 29224-3098
Phone (803) 788-2276
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| GP3390 | Medicaid | SC |
National Provider Directory
National Provider Directory- Tax ID family
- Carolina Cataract Clinic
- Part of
- Carolina Cataract Clinic
Other organizations with this tax ID 3
Organizations that report the same tax identification number in the National Provider Directory.
-
- Ophthalmology Physician
- Manning, SC
- NPI 1346425303
-
- Specialist
- Camden, SC
- NPI 1477701431
-
- Ophthalmology Physician
- Batesburg, SC
- NPI 1497930440
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Ophthalmology Physician
- Columbia, SC
- NPI 1427034040
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1200009600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1200960000000",
"number": "1811173602",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 23098",
"city": "COLUMBIA",
"state": "SC",
"postal_code": "292243098",
"telephone_number": "803-788-2276",
"fax_number": "803-788-1022"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "149 NORTH MAIN STREET",
"city": "WAGENER",
"state": "SC",
"postal_code": "29164",
"telephone_number": "803-788-2276",
"fax_number": "803-788-1022"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "CAROLINA CATARACT CLINIC",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "CAROLINA CATARACT CLINIC",
"enumeration_date": "2008-01-11",
"last_updated": "2008-01-22",
"status": "A",
"authorized_official_last_name": "JACOBS",
"authorized_official_first_name": "DEAN",
"authorized_official_middle_name": "R",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "803-788-2276",
"authorized_official_credential": "M.D."
},
"taxonomies": [
{
"code": "207W00000X",
"taxonomy_group": "",
"desc": "Ophthalmology",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "GP3390",
"state": "SC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Wagener, SC
- Sina Ayati, DMD
- Barnwell County Hospital (Wagener Medical Center)
- Barnwell County Hospital (Wagener Medical Center)
- Erin Patricia Beaudry, FNP
- Bela Family Dentistry of Wagener
- Carolina Rural Practice Management, Inc. (Wagener Medical Center)
- Dr. Vasant L. Garde
- Shaquanda Denae Dunbar
- John Robert Dunn III, M.D.
- Theresa Krafnick Dyches, RPH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.