Specialty Eye Care of the Carolinas, PC

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

17005 Issued in SC

Legal business name

SPECIALTY EYE CARE OF THE CAROLINAS, PC

Practice address

1115 48TH Ave N Ste 121
Myrtle Beach, SC 29577-5420

Phone

(843) 449-6478

Fax

(843) 497-8571

NPI assigned

Oct 31, 2007

Organization subpart

No

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

Authorized official

Name

Shawn F. Riley, MDNPI 1003873894

Title

President

Phone

(843) 449-6478

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in SC

Enrollment records 1

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Specialty Eye Care of the Carolinas, PC

  • Ophthalmology Physician
  • Supply, NC
  • NPI 1760661235

  4284628124

  Same PAC ID

Tax ID family

Specialty Eye Care of the Carolinas PC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Specialty Eye Care of the Carolinas, PC

  • Ophthalmology Physician
  • Supply, NC
  • NPI 1760661235
  NPD tax ID

Practitioners 3

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.

• Shawn F Riley, MD

  • Ophthalmology Physician
  • Myrtle Beach, SC
  • NPI 1003873894
  Medicare reassignment NPD Authorized official
• Samuel Edward Navon

  • Ophthalmology Physician
  • Gillette, WY
  • NPI 1962451336
  NPD (past)
• Scott William Tunis, M.D.

  • Ophthalmology Physician
  • Henderson, NC
  • NPI 1114975398
  NPD (past)

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

{
    "created_epoch": "1193788800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208649600000",
    "number": "1992984470",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1115 48TH AVE N STE 121",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295775420",
            "telephone_number": "843-449-6478",
            "fax_number": "843-497-8571"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1115 48TH AVE N STE 121",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295775420",
            "telephone_number": "843-449-6478",
            "fax_number": "843-497-8571"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPECIALTY EYE CARE OF THE CAROLINAS, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-31",
        "last_updated": "2008-04-20",
        "status": "A",
        "authorized_official_last_name": "RILEY",
        "authorized_official_first_name": "SHAWN",
        "authorized_official_middle_name": "F.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "843-449-6478",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "SC",
            "license": "17005",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "170059",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Southern Myrtle Inpatient Services, LLC
• Southern Oak Dental, LLC
• Southern Shores Urogynecology and Pelvic Reconstructive Surgery PC
• Victoria Nicole Spaar, OTR
• Sparkle Dental Center Inc.
• Specialty Pharmacy Myrtle Beach LLC (Specialty Pharmacy Myrtle Beach)
• Specialty Physical Therapy, LLC
• Shannon Michelle Spence, FNP
• Bailey Spencer, DO
• Wilma J Spencer, NP

• Ophthalmology Physician in Myrtle Beach, SC
• Providers in Myrtle Beach, 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 Apr 20, 2008; 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.