| Jervey Eye Group, Pa | |
|
1 Colony Centre Way, Simpsonville, SC 29681-3286 | |
| (864) 458-3900 | |
| (864) 967-9118 |
| Full Name | Jervey Eye Group, Pa |
|---|---|
| Type | Facility |
| Speciality | Ophthalmology |
| Location | 1 Colony Centre Way, Simpsonville, South Carolina |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447220710 | NPI | - | NPPES |
| CN1548 | Other | SC | MEDICARE RAILROAD |
| DE1061 | Other | SC | MEDICAID DMERC NUMBER |
| GP1669 | Medicaid | SC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 152W00000X | Optometrist | (* (Not Available)) | Secondary |
| 207W00000X | Ophthalmology | (* (Not Available)) | Primary |
| Provider Name | James W Culclasure |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1386614238 PECOS PAC ID: 1153213970 Enrollment ID: I20040326000821 |
| Provider Name | Joseph John Zinkovich |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1285856757 PECOS PAC ID: 0547229049 Enrollment ID: I20041008001381 |
| Provider Name | William H Ballinger |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1659341170 PECOS PAC ID: 1850320433 Enrollment ID: I20050804000835 |
| Provider Name | Brian Shelley |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1346274453 PECOS PAC ID: 7517976723 Enrollment ID: I20060417000733 |
| Provider Name | Brian A Welcome |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1851361505 PECOS PAC ID: 3274625264 Enrollment ID: I20100112000249 |
| Provider Name | Catherine S Bowden |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1477523132 PECOS PAC ID: 9234270240 Enrollment ID: I20100112000511 |
| Provider Name | David M Bowden |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1871563544 PECOS PAC ID: 7810889698 Enrollment ID: I20100112000520 |
| Provider Name | Steven M Andreasen |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1821002072 PECOS PAC ID: 0244360709 Enrollment ID: I20100609000489 |
| Provider Name | William D Coleman |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1275889503 PECOS PAC ID: 5193976595 Enrollment ID: I20121113000006 |
| Provider Name | Bridget M Whaley |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1144671900 PECOS PAC ID: 1557631082 Enrollment ID: I20170717001675 |
| Provider Name | Allison Bray Pariyadath |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1588957955 PECOS PAC ID: 2466772413 Enrollment ID: I20170828000930 |
| Provider Name | Ashley Grace Lesley |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1790761039 PECOS PAC ID: 8729273883 Enrollment ID: I20180411002067 |
| Provider Name | Scott A Davis |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1043694557 PECOS PAC ID: 4486962644 Enrollment ID: I20190911001409 |
| Provider Name | Carl T Bruce |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1043691124 PECOS PAC ID: 4284928169 Enrollment ID: I20200309000429 |
| Provider Name | Lara Rosenwasser Newman |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1033557368 PECOS PAC ID: 6800104589 Enrollment ID: I20210128002173 |
| Provider Name | Bradley Gustave |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1861636581 PECOS PAC ID: 3678716156 Enrollment ID: I20210209000316 |
| Provider Name | Garrison P Wier |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1992199970 PECOS PAC ID: 2365737210 Enrollment ID: I20210416001403 |
| Provider Name | Adam Pflugrath |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1134515042 PECOS PAC ID: 0143534545 Enrollment ID: I20210505002933 |
| Provider Name | Diem Thi Nguyen |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1669554812 PECOS PAC ID: 8820016595 Enrollment ID: I20220110000942 |
| Provider Name | Samantha Rodriguez |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1659630176 PECOS PAC ID: 9335375153 Enrollment ID: I20230118001538 |
| Provider Name | Michael Mequio |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1730328410 PECOS PAC ID: 2062676927 Enrollment ID: I20230525001978 |
| Provider Name | Valerie C Ferrell |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1437452380 PECOS PAC ID: 3971745035 Enrollment ID: I20231023000319 |
| Provider Name | Ramunas Rolius |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1598101933 PECOS PAC ID: 5496983827 Enrollment ID: I20250127001006 |
| Provider Name | Mary Braden Hendon Mallory |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1386483394 PECOS PAC ID: 1052836459 Enrollment ID: I20250417003347 |
| Provider Name | Justin J Kuiper |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1518340181 PECOS PAC ID: 5890008262 Enrollment ID: I20250424000494 |
| Mailing Address | Practice Location Address |
|---|---|
| Jervey Eye Group, Pa 601 Halton Rd, Greenville, SC 29607-3403 Ph: (864) 458-7956 | Jervey Eye Group, Pa 1 Colony Centre Way, Simpsonville, SC 29681-3286 Ph: (864) 458-3900 |