Organization Active NPI

Palmetto Eye Associates

Doing business as holly hill eye clinic

  • Optometrist
  • Holly Hill, SC
National Provider Identifier
1891932125
Registry record updated Jan 8, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1053 Issued in SC
Legal business name
PALMETTO EYE ASSOCIATES
Doing business as
holly hill eye clinic
Practice address
190 Rental Dr.
Holly Hill, SC 29059
Phone
(803) 496-5261
Fax
(803) 496-5261
NPI assigned
Jan 8, 2009
Last updated
Jan 8, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2009

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

Authorized official

Name
Dr. Jeff Pockl, OD
Title
Owner
Phone
(803) 496-5261

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1053 SC Primary

Addresses

Primary practice location

190 Rental Dr.
Holly Hill, SC 29059

Mailing address

PO Box 1030
Holly Hill, SC 29059-1030
Phone (803) 496-5261

Other identifiers 1

IdentifierTypeStateIssuer
DA9713MedicaidSC

Other names 1

  • holly hill eye clinic Doing business as

National Provider Directory

National Provider Directory

Locations

190 Rental Dr
SC 29059

190 Business Park Dr
Santee, SC 29142
Phone (803) 854-2682

Practitioners & affiliated clinicians

Practitioners 1

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": "1231372800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1231372800000",
    "number": "1891932125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1030",
            "city": "HOLLY HILL",
            "state": "SC",
            "postal_code": "290591030",
            "telephone_number": "803-496-5261",
            "fax_number": "803-496-5261"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "190 RENTAL DR.",
            "city": "HOLLY HILL",
            "state": "SC",
            "postal_code": "29059",
            "telephone_number": "803-496-5261",
            "fax_number": "803-496-5261"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PALMETTO EYE ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-01-08",
        "last_updated": "2009-01-08",
        "status": "A",
        "authorized_official_last_name": "POCKL",
        "authorized_official_first_name": "JEFF",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "803-496-5261",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "SC",
            "license": "1053",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "DA9713",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "holly hill eye clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Holly Hill, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2009; 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.