Organization Active NPI

Eyes Over Carolina PC

  • Optometrist
  • Hartsville, SC
National Provider Identifier
1861803520
Registry record updated Mar 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1696 Issued in SC
Legal business name
EYES OVER CAROLINA PC
Practice address
1150 S 4TH St
Hartsville, SC 29550-0705
Phone
(843) 857-1999
Fax
(803) 227-8996
NPI assigned
May 15, 2014
Last updated
Mar 23, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2026

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

Authorized official

Name
Dr. Edwin Kyle Mitchell, ODNPI 1700132719
Title
Owner
Phone
(336) 707-6542

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1696 SC Primary
Corneal and Contact Management Optometrist 152WC0802X 1696 SC
Pediatric Optometrist 152WP0200X 1696 SC

Addresses

Primary practice location

1150 S 4TH St
Hartsville, SC 29550-0705

Mailing address

356 Woodlander Dr
Blythewood, SC 29016-7621
Phone (803) 776-5363

Other practice location 1

7520 Garners Ferry Rd
Columbia, SC 29209-2628
Phone (803) 776-5363

Other practice location 2

1283 Broad St
Sumter, SC 29150-1973
Phone (803) 905-0520

Other identifiers 3

IdentifierTypeStateIssuer
DA9529MedicaidSC
DA9570MedicaidSC
DA9574MedicaidSC

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20151019001466 SC Part B Supplier - Clinic/Group Practice 6002125838 Receives reassigned benefits from 5 practitioners
Practice locations: Columbia, SC; Hartsville, SC; Lancaster, SC; Sumter, SC

National Provider Directory

National Provider Directory

Locations

1150 S 4th St
Hartsville, SC 29550
Phone (843) 332-8111

Practitioners & affiliated clinicians

Practitioners 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1400112000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1774224000000",
    "number": "1861803520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "356 WOODLANDER DR",
            "city": "BLYTHEWOOD",
            "state": "SC",
            "postal_code": "290167621",
            "telephone_number": "803-776-5363",
            "fax_number": "803-227-8996"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1150 S 4TH ST",
            "city": "HARTSVILLE",
            "state": "SC",
            "postal_code": "295500705",
            "telephone_number": "843-857-1999",
            "fax_number": "803-227-8996"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7520 Garners Ferry Rd",
            "address_purpose": "LOCATION",
            "city": "Columbia",
            "state": "SC",
            "postal_code": "292092628",
            "country_code": "US",
            "telephone_number": "803-776-5363",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1283 Broad St",
            "address_purpose": "LOCATION",
            "city": "Sumter",
            "state": "SC",
            "postal_code": "291501973",
            "country_code": "US",
            "telephone_number": "803-905-0520",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "EYES OVER CAROLINA PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-05-15",
        "last_updated": "2026-03-23",
        "certification_date": "2026-03-23",
        "status": "A",
        "authorized_official_last_name": "MITCHELL",
        "authorized_official_first_name": "EDWIN",
        "authorized_official_middle_name": "KYLE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "336-707-6542",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "SC",
            "license": "1696",
            "primary": true
        },
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "SC",
            "license": "1696",
            "primary": false
        },
        {
            "code": "152WP0200X",
            "taxonomy_group": "",
            "desc": "Optometrist, Pediatrics",
            "state": "SC",
            "license": "1696",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "DA9529",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "DA9570",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "DA9574",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hartsville, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2026; 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.