Integrated Vision Associates LLC

Primary specialty

OptometristTaxonomy code 152W00000X

License

SC1045 Issued in SC

Legal business name

INTEGRATED VISION ASSOCIATES LLC

Practice address

1001 Main St S
Greenwood, SC 29646-3230

Phone

(864) 223-1960

Fax

(864) 223-1627

NPI assigned

Aug 19, 2016

Last updated

Apr 4, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Eric R Bang, ODNPI 1255493680

Title

Owner

Phone

(864) 223-1960

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in SC

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

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.

• Eric Riley Bang, OD

  • Optometrist
  • Greenwood, SC
  • NPI 1255493680
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1471564800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1649030400000",
    "number": "1962957902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 OAK DR",
            "city": "ANDERSON",
            "state": "SC",
            "postal_code": "296252908",
            "telephone_number": "864-223-1960"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 MAIN ST S",
            "city": "GREENWOOD",
            "state": "SC",
            "postal_code": "296463230",
            "telephone_number": "864-223-1960",
            "fax_number": "864-223-1627"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "508 Bypass 72 NW",
            "address_2": "Inside Wal-Mart",
            "address_purpose": "LOCATION",
            "city": "Greenwood",
            "state": "SC",
            "postal_code": "296491300",
            "country_code": "US",
            "telephone_number": "864-223-1960",
            "fax_number": "864-223-1627",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "INTEGRATED VISION ASSOCIATES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-08-19",
        "last_updated": "2022-04-04",
        "certification_date": "2022-04-04",
        "status": "A",
        "authorized_official_last_name": "BANG",
        "authorized_official_first_name": "ERIC",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "864-223-1960",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "SC",
            "license": "SC1045",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "DA9531",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Optometrist in Greenwood, SC
• Providers in Greenwood, SC by specialty
• Optometrist in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.