NPIMap

Organization Active NPI

Macmillan Optical, Inc.

  • Optometrist
  • Spartanburg, SC
National Provider Identifier
1972628055
Registry record updated Aug 11, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
991 Issued in SC
Legal business name
MACMILLAN OPTICAL, INC.
Practice address
227 E Blackstock Rd
Suite 200
Spartanburg, SC 29301-2631
Phone
(864) 576-0564
Fax
(864) 576-0594
NPI assigned
Mar 20, 2007
Organization subpart
Yes
Parent organization
MACMILLAN, OPTICAL, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 11, 2008

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

Authorized official

Name
Dr. Tom Macmillan, OD
Title
Owner
Phone
(864) 576-0564

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 991 SC Primary

Addresses

Primary practice location

227 E Blackstock Rd
Suite 200
Spartanburg, SC 29301-2631

Mailing address

227 E Blackstock Rd
Suite 200
Spartanburg, SC 29301-2631
Phone (864) 576-0564

Other identifiers 1

IdentifierTypeStateIssuer
DO9916MedicaidSC

Other names 1

  • Spartanburg Vision West Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Macmillan Optical Inc3 organizations share this tax ID, including this one
Part of
Macmillan Optical Inc

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

227 E Blackstock Rd
Ste 200
Spartanburg, SC 29301
Phone (864) 576-0564

NPI Registry JSON

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

{
    "created_epoch": "1174348800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1218412800000",
    "number": "1972628055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "227 E BLACKSTOCK RD",
            "address_2": "SUITE 200",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "293012631",
            "telephone_number": "864-576-0564",
            "fax_number": "864-576-0594"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "227 E BLACKSTOCK RD",
            "address_2": "SUITE 200",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "293012631",
            "telephone_number": "864-576-0564",
            "fax_number": "864-576-0594"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MACMILLAN OPTICAL, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MACMILLAN, OPTICAL, INC",
        "enumeration_date": "2007-03-20",
        "last_updated": "2008-08-11",
        "status": "A",
        "authorized_official_last_name": "MACMILLAN",
        "authorized_official_first_name": "TOM",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "864-576-0564",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "SC",
            "license": "991",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "DO9916",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Spartanburg Vision West",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Spartanburg, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2008; 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.