Individual provider Active NPI

Kate D Tarver, OD

  • Optometrist
  • West Columbia, SC
National Provider Identifier
1912310897
Registry record updated Aug 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1816 Issued in SC
Practice address
3618 Sunset Blvd Ste a
West Columbia, SC 29169-3046
Phone
(803) 732-4099
Fax
(803) 227-8992
NPI assigned
Jun 9, 2014
Last updated
Aug 26, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1816 SC Primary
Vision Therapy Optometrist 152WV0400X 1816 SC

Addresses

Primary practice location

3618 Sunset Blvd Ste a
West Columbia, SC 29169-3046

Mailing address

3618 Sunset Blvd Ste a
West Columbia, SC 29169-3046
Phone (803) 413-9618

Other identifiers 1

IdentifierTypeStateIssuer
D18167MedicaidSC

Other names 1

  • Kate L Davis Former name

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20150702002568 SC Practitioner - Optometry 8224340286 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Vision Therapy Institute of SCGroup PAC ID 5799115044, 3 clinicians

Practice addresses (Care Compare)

3618 Sunset Blvd
Suite a
West Columbia, SC 29169-3046
Phone (803) 732-4099

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1816SCMDVeterinarian

Practice roles

OrganizationSpecialtyStatusNew patients
Vision Therapy Institute of SC Optometrist CurrentSince Oct 5, 2019 Accepting new patients
Dry Eye Center of Beaufort Optometrist CurrentSince Mar 13, 2024 Accepting new patients

Locations

970 Ribaut Rd
Ste 2
Beaufort, SC 29902
Phone (843) 510-7342

1620 Browning Rd
Columbia, SC 29210
Phone (803) 732-4099

3618 Sunset Blvd
#A
West Columbia, SC 29169
Phone (803) 732-4099

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1402272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629936000000",
    "number": "1912310897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3618 SUNSET BLVD STE A",
            "city": "WEST COLUMBIA",
            "state": "SC",
            "postal_code": "291693046",
            "telephone_number": "803-413-9618"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3618 SUNSET BLVD STE A",
            "city": "WEST COLUMBIA",
            "state": "SC",
            "postal_code": "291693046",
            "telephone_number": "803-732-4099",
            "fax_number": "803-227-8992"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TARVER",
        "first_name": "KATE",
        "middle_name": "D",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-09",
        "last_updated": "2021-08-26",
        "certification_date": "2021-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "SC",
            "license": "1816",
            "primary": true
        },
        {
            "code": "152WV0400X",
            "taxonomy_group": "",
            "desc": "Optometrist, Vision Therapy",
            "state": "SC",
            "license": "1816",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "D18167",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATE",
            "last_name": "DAVIS",
            "middle_name": "L",
            "credential": "OD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in West Columbia, SC

Sources for this page

Verify at the official NPI Registry.