NPIMap

Organization Active NPI

Carolina Forest Family Eyecare, P.a.

  • Optometrist
  • Myrtle Beach, SC
National Provider Identifier
1972621423
Registry record updated Oct 3, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1404 Issued in SC
Legal business name
CAROLINA FOREST FAMILY EYECARE, P.A.
Practice address
3874 Renee Dr
Suite D
Myrtle Beach, SC 29579
Phone
(843) 903-6262
Fax
(843) 903-6228
NPI assigned
Mar 26, 2007
Last updated
Oct 3, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2012

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

Authorized official

Name
Dr. Thomas Weshefsky, O.D.NPI 1710997242
Title
President
Phone
(843) 903-0068

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1404 SC Primary

Addresses

Primary practice location

3874 Renee Dr
Suite D
Myrtle Beach, SC 29579

Mailing address

3874 Renee Dr
Suite D
Myrtle Beach, SC 29579
Phone (843) 903-6262

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070710000657 SC Part B Supplier - Clinic/Group Practice 2163522822 Receives reassigned benefits from 3 practitioners
Practice locations: Myrtle Beach, SC

National Provider Directory

National Provider Directory

Locations

4225 Carolina Exchange Dr
Myrtle Beach, SC 29579
Phone (843) 903-6262

4225 Carolina Exchange Dr
#A
Myrtle Beach, SC 29579
Phone (843) 903-6262

Practitioners & affiliated clinicians

Practitioners 19

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.

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1174867200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1349222400000",
    "number": "1972621423",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3874 RENEE DR",
            "address_2": "SUITE D",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "29579",
            "telephone_number": "843-903-6262",
            "fax_number": "843-903-6228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3874 RENEE DR",
            "address_2": "SUITE D",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "29579",
            "telephone_number": "843-903-6262",
            "fax_number": "843-903-6228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAROLINA FOREST FAMILY EYECARE, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-26",
        "last_updated": "2012-10-03",
        "status": "A",
        "authorized_official_last_name": "WESHEFSKY",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "843-903-0068",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "SC",
            "license": "1404",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Myrtle Beach, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2012; 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.