Grand Strand Vision Services, Inc.

Primary specialty

Vision Therapy OptometristTaxonomy code 152WV0400X

Legal business name

GRAND STRAND VISION SERVICES, INC.

Practice address

4886 Socastee Blvd
Myrtle Beach, SC 29588-7245

Phone

(843) 293-1555

Fax

(843) 293-8102

NPI assigned

Jul 15, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Mark Tracy Dean, ODNPI 1164491718

Title

Owner

Phone

(843) 293-1555

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in SC

Enrollment records 1

Locations

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.

• Mark Tracy Dean, OD

  • Vision Therapy Optometrist
  • Myrtle Beach, SC
  • NPI 1164491718
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1152921600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1318723200000",
    "number": "1942226337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4886 SOCASTEE BLVD",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295887245",
            "telephone_number": "843-293-1555",
            "fax_number": "843-293-8102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4886 SOCASTEE BLVD",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295887245",
            "telephone_number": "843-293-1555",
            "fax_number": "843-293-8102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRAND STRAND VISION SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-15",
        "last_updated": "2011-10-16",
        "status": "A",
        "authorized_official_last_name": "DEAN",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "TRACY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "843-293-1555",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152WV0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist, Vision Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "DA9697",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Grand Strand Senior Health Center, LLC
• Grand Strand Specialty Associates, LLC
• Grand Strand Surgical Specialists, LLC
• Grand Strand Surgical Specialists, LLC
• Grand Strand Urology
• Grande Dunes OBGYN and Facial Aesthetics PA
• Grandstrand Comfort Care LLC
• John P Grant, D.C.
• Pamela Grant
• Anthony John Grasso, ADC

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.