Larry F Jerge, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

1468 Issued in SC

Practice address

1151 Stonecrest Blvd.
Fort Mill, SC 29708

Phone

(803) 802-4733

Fax

(803) 802-4735

NPI assigned

Jul 26, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

Practice roles

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

• Tega Cay Eye Care, LLC

  • Optometrist
  • Tega Cay, SC
  • NPI 1043482722
  Authorized official Same address or phone
• Andrew J. Siedlecki, M.D., PC

  dba Siedlecki Cataract and Vision Care

  • Ophthalmology Physician
  • Williamsville, NY
  • NPI 1689884488
  NPD (past)

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

{
    "created_epoch": "1122336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1204588800000",
    "number": "1861492407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 PINE LINKS DR",
            "city": "TEGA CAY",
            "state": "SC",
            "postal_code": "297087205",
            "telephone_number": "803-325-4298"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1151 STONECREST BLVD.",
            "city": "FORT MILL",
            "state": "SC",
            "postal_code": "29708",
            "telephone_number": "803-802-4733",
            "fax_number": "803-802-4735"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JERGE",
        "first_name": "LARRY",
        "middle_name": "F",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-26",
        "last_updated": "2008-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "UT-003877-1",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "SC",
            "license": "1468",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "D14688",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Elizabeth A Jarrett, ATC
• Jasper Dentistry
• Michele Moreschi Jasper, D.D.S.
• JD Connect of South Carolina LLC
• Meghan Kathleen Jensen, AU.D.
• Sital Jethwa
• Andrew Mergen Johnson, DPT
• Emily N Johnson, PHARMD
• Latonia K Johnson, LCSW
• Lisa Marie Johnson, LM

• Optometrist in Fort Mill, SC
• Providers in Fort Mill, SC by specialty
• Optometrist in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.