MONTGOMERY & RIDDLE EYECARE, PA (NPI# 1265476584) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1265476584 |
| Entity Type | Organization |
| Organization Name | MONTGOMERY & RIDDLE EYECARE, PA |
| Other Organization Name | MONTGOMERY EYE ASSOCIATES |
| Practice Address |
22995 Highway 76 E Clinton SC 29325-7529 |
| Practice Telephone | 8648330038 |
| Practice Fax Number | 8648330520 |
| Mailing Telephone | 8648330038 |
| Mailing Fax Number | 8648330520 |
| Enumeration Date | 2006-06-16 |
| Last Update Date | 2017-03-15 |
| Authorized Official Name | DR. SAMUEL JACOB MONTGOMERY JR. (PRESIDENT) |
| Authorized Official Telephone | 8648330038 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207W00000X | Ophthalmology | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SC | MEDICARE GROUP NUMBER | 7427 | 01 |
| SC | GP3567 | 05 | |
| SC | RAILROAD MEDICARE | CJ9961 | 01 |
| Other Name | Type Code |
|---|---|
| Montgomery Eye Associates | Former Legal Business Name - Organization |
| Street Address |
22995 HIGHWAY 76 E |
| City | CLINTON |
| State | SC |
| Zip Code | 29325-7529 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609211853 | Diviyesh Bhagvanji Patel | Optometrist | 22995 Highway 76 E, Clinton, SC 29325-7529 | 2013-05-01 |
| 1073755427 | Balaji Perumal | Ophthalmology | 22995 Highway 76 E, Clinton, SC 29325-7529 | 2009-04-01 |
| 1134155955 | Harvard Keith Riddle Jr. | Ophthalmology | 22995 Highway 76 E, Clinton, SC 29325-7529 | 2006-06-23 |
| 1467488551 | Samuel Jacob Montgomery Jr. | Ophthalmology | 22995 Highway 76 E, Clinton, SC 29325-7529 | 2006-06-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295353100 | Mason Paige Gambrell | Student in an Organized Health Care Education/Training Program | 107 Shellcreek Ct, Clinton, SC 29325 | 2020-07-07 |
| 1386207975 | Tammy Binger | Registered Nurse | 22725 U.S. 76, Clinton, SC 29325 | 2019-04-18 |
| 1154828945 | Lillian Smith | Physical Therapy Assistant | Nhc Clinton, 304 Jacobs Highway, Clinton, SC 29325 | 2018-04-09 |
| 1134519366 | Nora Pace | Specialist/Technologist | 18132 Hwy 72 E, Clinton, SC 29325 | 2015-01-26 |
| 1497186845 | John M. Griz | Orthopaedic Surgery | 22971 Hwy 76e, Clinton, SC 29325 | 2013-12-11 |
| 1992131171 | Sharon Kay Stoia | Occupational Therapist | 600 Plaza Circle, Clinton, SC 29325 | 2013-09-19 |
| 1578800256 | Hayes Ambulance Service LLC | Ambulance | 2143 Torrington Road, Clinton, SC 29325 | 2013-01-14 |
| 1083943518 | Margaret Estelle Shreve | Chiropractor | 209 Musgrove St, Clinton, SC 29325 | 2009-12-11 |
| 1750556213 | Piedmont Regional Urology | Urology | 300 Plantation Plaza, Suite F, Clinton, SC 29325 | 2008-04-25 |
| 1285821587 | Assisted Living Concepts Inc | Assisted Living Facility | 939 Springdale Drive, Clinton, SC 29325 | 2007-10-01 |
| Find all providers in zip 29325 | ||||
| Taxonomy Code | 207W00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Ophthalmology |
| An ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Ophthalmology, 2007. http://www.abop.org/. American Osteopathic Board of Ophthalmology and Otolaryngology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Ophthalmology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992003677 | Virdi Eye Clinic of Iowa | Ophthalmology | 1015 13th Ave N, Clinton, IA 52732-3479 | 2011-03-04 |
| 1093881344 | Paul Shannon Cunningham | Ophthalmology | 9131 Piscataway Rd Ste 150, Clinton, MD 20735-2510 | 2006-11-28 |
| 1912978735 | Thomas J Woods | Ophthalmology | 603 Beamon St, Clinton, NC 28328-2650 | 2006-01-30 |
| 1659374957 | Garry A Land | Ophthalmology | 2315 16th St Nw, Clinton, IA 52732-3305 | 2005-05-31 |
| 1821091232 | Robert Thomas Barowsky | Ophthalmology | 340a Northeast Blvd, Jordan Shopping Center, Clinton, NC 28328-2424 | 2005-05-31 |
| 1073755427 | Balaji Perumal | Ophthalmology | 22995 Highway 76 E, Clinton, SC 29325-7529 | 2009-04-01 |
| 1649449224 | Thomas Jc Woods Md Pa | Ophthalmology | 603 Beaman St, Clinton, NC 28328-2650 | 2008-02-27 |
| 1336362623 | Land Eye Center, Plc | Ophthalmology | 2315 16th St Nw, Clinton, IA 52732-3305 | 2007-04-11 |
| 1609942945 | Paul Shannon Cunningham | Ophthalmology | 9131 Piscataway Road, #150, Clinton, MD 20735 | 2006-11-28 |
| 1134155955 | Harvard Keith Riddle Jr. | Ophthalmology | 22995 Highway 76 E, Clinton, SC 29325-7529 | 2006-06-23 |
| Find all providers in CLINTON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.