Organization Active NPI

Lessco, Inc.

  • Optometrist
  • North Charleston, SC
National Provider Identifier
1831248483
Registry record updated May 5, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1131 Issued in SC
Legal business name
LESSCO, INC.
Doing business as
Lesslie Vision Care
Practice address
1370 Remount Rd
Suite B
North Charleston, SC 29406-3322
Phone
(843) 747-7663
Fax
(843) 747-7665
NPI assigned
Jan 10, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 5, 2011

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

Authorized official

Name
Dr. Jennifer Maize Lesslie, O.D.NPI 1518052083
Title
Owner
Phone
(843) 747-7663

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)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 1131 SC Primary

Addresses

Primary practice location

1370 Remount Rd
Suite B
North Charleston, SC 29406-3322

Mailing address

1370 Remount Rd
Suite B
North Charleston, SC 29406-3322
Phone (843) 747-7663

Other identifiers 2

IdentifierTypeStateIssuer
DA9770MedicaidSC
D11315MedicaidSC

Other names 1

  • Lesslie Vision Care Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041011000365 SC Part B Supplier - Clinic/Group Practice 9537128913 Receives reassigned benefits from 2 practitioners
Practice locations: N Charleston, SC

National Provider Directory

National Provider Directory

Locations

1370 Remount Rd
Ste B
North Charleston, SC 29406
Phone (843) 747-7663

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1168387200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1304553600000",
    "number": "1831248483",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1370 REMOUNT RD",
            "address_2": "SUITE B",
            "city": "NORTH CHARLESTON",
            "state": "SC",
            "postal_code": "294063322",
            "telephone_number": "843-747-7663",
            "fax_number": "843-747-7665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1370 REMOUNT RD",
            "address_2": "SUITE B",
            "city": "NORTH CHARLESTON",
            "state": "SC",
            "postal_code": "294063322",
            "telephone_number": "843-747-7663",
            "fax_number": "843-747-7665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LESSCO, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-10",
        "last_updated": "2011-05-05",
        "status": "A",
        "authorized_official_last_name": "LESSLIE",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "MAIZE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "843-747-7663",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "SC",
            "license": "1131",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "DA9770",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "D11315",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lesslie Vision Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in North Charleston, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2011; 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.