Individual provider Active NPI

Sherry J Gilmer, O.D.

  • Optometrist
  • Greenville, SC
National Provider Identifier
1831262435
Registry record updated Mar 28, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1025 Issued in SC
Practice address
3925 Pelham Rd
Greenville, SC 29615-5004
Phone
(864) 288-8224
NPI assigned
Nov 15, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 28, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X TUV006582 NY
Optometrist 152W00000X 1025 SC Primary

Addresses

Primary practice location

3925 Pelham Rd
Greenville, SC 29615-5004

Mailing address

305 Grove Rd
Greenville, SC 29605-4112
Phone (864) 234-8786

Other names 1

  • Sherry L Johnson Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041012001353 SC Practitioner - Optometry 6305806589 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
TUV006582NYMDOptometrist
006582NYMDAcupuncturist

Practice roles

OrganizationSpecialtyStatusNew patients
Sherry J. Gilmer, OD LLC Optometrist CurrentSince Jan 1, 2022 Accepting new patients
Tidewater Eyecare, LLC Optometrist Past Accepting new patients
Optical Impressions, a Limited Liability Corporation Optometrist Past Accepting new patients

Locations

3925 Pelham Rd
Greenville, SC 29615
Phone (864) 234-8786

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1163548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522195200000",
    "number": "1831262435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "305 GROVE RD",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296054112",
            "telephone_number": "864-234-8786",
            "fax_number": "864-234-8756"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3925 PELHAM RD",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296155004",
            "telephone_number": "864-288-8224"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILMER",
        "first_name": "SHERRY",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-15",
        "last_updated": "2018-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "TUV006582",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "SC",
            "license": "1025",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHERRY",
            "last_name": "JOHNSON",
            "middle_name": "L",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Greenville, SC

Sources for this page

Verify at the official NPI Registry.