Carolina Macular and Retinal Care LLC

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

29610 Issued in SC

Legal business name

CAROLINA MACULAR AND RETINAL CARE LLC

Practice address

613 Long Point Rd
Suite 201
Mt Pleasant, SC 29464-8350

Phone

(843) 724-3456

Fax

(843) 724-3455

NPI assigned

Jun 18, 2008

Organization subpart

No

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

Authorized official

Name

Dr. John D Gross, MDNPI 1710995543

Title

President

Phone

(843) 724-3456

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Carolina Macula & Retina Other name

Medicare fee-for-service enrollment

Enrolled in SC

Enrollment records 1

Locations

Practitioners 1

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

• John D Gross, M.D.

  • Ophthalmology Physician
  • Mt Pleasant, SC
  • NPI 1710995543

  Ophthalmology, SC

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1213747200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1437350400000",
    "number": "1992966477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "613 LONG POINT RD",
            "address_2": "SUITE 201",
            "city": "MT PLEASANT",
            "state": "SC",
            "postal_code": "294648350",
            "telephone_number": "843-724-3456",
            "fax_number": "843-724-3455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "613 LONG POINT RD",
            "address_2": "SUITE 201",
            "city": "MT PLEASANT",
            "state": "SC",
            "postal_code": "294648350",
            "telephone_number": "843-724-3456",
            "fax_number": "843-724-3455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAROLINA MACULAR AND RETINAL CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-18",
        "last_updated": "2015-07-20",
        "status": "A",
        "authorized_official_last_name": "GROSS",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "843-724-3456",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "SC",
            "license": "29610",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP4917",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Carolina Macula & Retina",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Carolina Imaging Consultants P a
• Carolina Imaging Specialists, LLC
• Carolina Independent Id, LLC
• Carolina Park Family Dentistry LLC
• Carolina Respite Care, LLC
• Carolina Therapy Center
• Carolina Wren Anesthesia Services, LLC
• Elizabeth Carpenter, DVM

• Ophthalmology Physician in Mt Pleasant, SC
• Providers in Mt Pleasant, SC by specialty
• Ophthalmology Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2015; 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.