Active NPI
Lloyd W Nethercutt Jr., OD
- Optometrist
- Sumter, SC
National Provider Identifier
1922044429
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 615
- Practice address
- 701 Bultman Drive
Sumter, SC 29150 - Phone
- (803) 773-4723
- Fax
- (803) 775-5211
- NPI assigned
- Jun 22, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 615 | SC | Primary |
Addresses
Primary practice location
701 Bultman Drive
Sumter, SC 29150
Mailing address
PO Box 5721
Columbia, SC 29250
Phone (803) 779-2273
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 20005987 | Other | SC | SELECT HEALTH OF SC |
| D06152 | Medicaid | SC |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 615 | SC | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Landmark Leasing Inc | Optometrist | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Optometrist
- Sumter, SC
- NPI 1538104963
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150934400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1922044429",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 5721",
"city": "COLUMBIA",
"state": "SC",
"postal_code": "29250",
"telephone_number": "803-779-2273",
"fax_number": "803-799-0854"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "701 BULTMAN DRIVE",
"city": "SUMTER",
"state": "SC",
"postal_code": "29150",
"telephone_number": "803-773-4723",
"fax_number": "803-775-5211"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NETHERCUTT",
"first_name": "LLOYD",
"middle_name": "W",
"name_suffix": "Jr.",
"credential": "OD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-22",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "SC",
"license": "615",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SELECT HEALTH OF SC",
"identifier": "20005987",
"state": "SC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "D06152",
"state": "SC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Sumter, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.