Healthy Eyes Vision Group LLC

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

HEALTHY EYES VISION GROUP LLC

Practice address

1518 Pickens St
Columbia, SC 29201-3449

Phone

(803) 665-3269

NPI assigned

Feb 10, 2020

Organization subpart

No

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

Authorized official

Name

Peter Candela, ODNPI 1689638405

Title

Owner

Phone

(803) 306-6121

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Healthy Eyes on Pickens Doing business as

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Peter V Candela, OD

  • Optometrist
  • Columbia, SC
  • NPI 1689638405
  NPD Authorized official

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

{
    "created_epoch": "1581292800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1591747200000",
    "number": "1972135754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2745 BURNEY DR",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292053120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1518 PICKENS ST",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292013449",
            "telephone_number": "803-665-3269"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTHY EYES VISION GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-02-10",
        "last_updated": "2020-06-10",
        "certification_date": "2020-06-10",
        "status": "A",
        "authorized_official_last_name": "CANDELA",
        "authorized_official_first_name": "PETER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "803-306-6121",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "DA9585",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Healthy Eyes on Pickens",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Healthy Eyes on Pickens",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• All providers in Columbia, SC
• Optometrist in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2020; 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.