Individual provider Active NPI

Amy M Brown, O.D.

  • Optometrist
  • Central, SC
National Provider Identifier
1972678589
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1281 Issued in SC
Practice address
1286 Eighteen Mile Rd
Central, SC 29630
Phone
(864) 639-2142
NPI assigned
Nov 21, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1281 SC Primary

Addresses

Primary practice location

1286 Eighteen Mile Rd
Central, SC 29630

Mailing address

185 Sunset Rd
Pickens, SC 29671-9664
Phone (864) 639-2142

Other identifiers 1

IdentifierTypeStateIssuer
D12813MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041216000540 SC Practitioner - Optometry 9638136153 Practice locations: Central, SC

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pennsylvania College of Optometry, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1286 Eighteen Mile Rd
Central, SC 29630-8605
Phone (864) 639-2142

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Macmillan Optical, Inc PastSince Jan 1, 2006 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1164067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1972678589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "185 SUNSET RD",
            "city": "PICKENS",
            "state": "SC",
            "postal_code": "296719664",
            "telephone_number": "864-639-2142",
            "fax_number": "864-639-4012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1286 EIGHTEEN MILE RD",
            "city": "CENTRAL",
            "state": "SC",
            "postal_code": "29630",
            "telephone_number": "864-639-2142"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "AMY",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "SC",
            "license": "1281",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "D12813",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Central, SC

Sources for this page

Verify at the official NPI Registry.