Benjamin C Poole, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

SC 728 Issued in SC

Practice address

121 Bethel St
Clover, SC 29710-1101

Phone

(803) 222-9538

Fax

(803) 222-1898

NPI assigned

Apr 26, 2006

Last updated

May 19, 2016By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in NC, SC2 enrollments

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 2

Specialty

Optometry

Education

Illinois College of Optometry at Chicago, 1982

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Poole Eyecare PAGroup PAC ID 8729135603, shared by 2 NPIs, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: bpoole@pooleeye.intellechartdirect.net

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.

• Poole Eyecare PA

  • Optometrist
  • Clover, SC
  • NPI 1699733501
  Medicare reassignment NPD Authorized official
• Poole Eyecare PA

  • Optometrist
  • Kings MTN, NC
  • NPI 1962450098
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1146009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1463616000000",
    "number": "1871550897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 BETHEL ST",
            "city": "CLOVER",
            "state": "SC",
            "postal_code": "297101101",
            "telephone_number": "803-222-9538",
            "fax_number": "803-222-1898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 BETHEL ST",
            "city": "CLOVER",
            "state": "SC",
            "postal_code": "297101101",
            "telephone_number": "803-222-9538",
            "fax_number": "803-222-1898"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POOLE",
        "first_name": "BENJAMIN",
        "middle_name": "C",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-26",
        "last_updated": "2016-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NC",
            "license": "NC1109",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "SC",
            "license": "SC 728",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89-09655",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF NC",
            "identifier": "09655",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF SC",
            "identifier": "570788101001",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "D07286",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Marion Patterson
• Abhinaya Muralidharan Perumbedu
• Jill Ann Pierce, MS, CCC/SLP
• Yasmin Plummer, LPN
• Poole Eyecare PA
• Zachary Barton Poole, MD
• Hali Porter, MCD, CCC-SLP
• Cheryl Moody Price, MSP, CCC-SLP
• Priceless Therapy Services, LLC
• Real Connections Counseling and Wellness LLC (Real Connections)

• Optometrist in Clover, SC
• Providers in Clover, SC by specialty
• Optometrist in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2016; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.