Surge Eye Associates, LLC

Primary specialty

OptometristTaxonomy code 152W00000X

License

0618001011 Issued in VA

Legal business name

SURGE EYE ASSOCIATES, LLC

Practice address

240 Lands End Blvd
Myrtle Beach, SC 29572-7054

Phone

(843) 457-2020

NPI assigned

Oct 14, 2016

Organization subpart

No

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

Authorized official

Name

Dr. Christie A Altice-Weaver, OD

Title

Owner

Phone

(843) 457-2020

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Surge Eye Associates, LLC Doing business as

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

{
    "created_epoch": "1476403200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1476403200000",
    "number": "1891246823",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "240 LANDS END BLVD",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295727054",
            "telephone_number": "843-457-2020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "240 LANDS END BLVD",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295727054",
            "telephone_number": "843-457-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SURGE EYE ASSOCIATES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-14",
        "last_updated": "2016-10-14",
        "status": "A",
        "authorized_official_last_name": "ALTICE-WEAVER",
        "authorized_official_first_name": "CHRISTIE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "843-457-2020",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "VA",
            "license": "0618001011",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009237267",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Surge Eye Associates, LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Optometrist in Myrtle Beach, SC
• Providers in Myrtle Beach, SC by specialty
• Optometrist in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.