NPIMap

Organization Active NPI

Orangeburg Optometric LLC

  • Optometrist
  • Orangeburg, SC
National Provider Identifier
1992874671
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1105 Issued in SC
Legal business name
ORANGEBURG OPTOMETRIC LLC
Practice address
1530 Chestnut St
Orangeburg, SC 29115-3426
Phone
(803) 535-2000
Fax
(803) 536-2020
NPI assigned
Nov 7, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Shane L Spittler, O.D.NPI 1528040243
Title
Doctor
Phone
(803) 535-2000

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
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 1105 SC Primary

Addresses

Primary practice location

1530 Chestnut St
Orangeburg, SC 29115-3426

Mailing address

1530 Chestnut St
Orangeburg, SC 29115-3426
Phone (803) 535-2000

Other identifiers 1

IdentifierTypeStateIssuer
D11057MedicaidSC

Other names 1

  • H Rubin Vision Center Doing business as

National Provider Directory

National Provider Directory

Locations

1530 Chestnut St
Orangeburg, SC 29115
Phone (803) 535-2000

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1162857600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1992874671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1530 CHESTNUT ST",
            "city": "ORANGEBURG",
            "state": "SC",
            "postal_code": "291153426",
            "telephone_number": "803-535-2000",
            "fax_number": "803-536-2020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1530 CHESTNUT ST",
            "city": "ORANGEBURG",
            "state": "SC",
            "postal_code": "291153426",
            "telephone_number": "803-535-2000",
            "fax_number": "803-536-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORANGEBURG OPTOMETRIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-07",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SPITTLER",
        "authorized_official_first_name": "SHANE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "803-535-2000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "SC",
            "license": "1105",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "D11057",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "H Rubin Vision Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Orangeburg, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.