INDIGO VISION CENTER PA NPI 1700071149

NPI Information

  • NPI: 1700071149
  • Provider Name: INDIGO VISION CENTER PA
  • Classification: Optometrist - 152W00000X
  • Entity Type: Organization
  • CLIA Number: 42D2075411
  • Address: 302 CHURCH ST
    GEORGETOWN, SC
    ZIP 29440
  • Phone: (843) 546-2244

Map and Directions

Get Directions

NPI Details

INDIGO VISION CENTER PA is an optometrist in Georgetown, SC. The provider is doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system. INDIGO VISION CENTER PA NPI is 1700071149. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

302 CHURCH ST
GEORGETOWN, SC
ZIP 29440-406
Phone: (843) 546-2244
Fax: (843) 546-2255

The provider's authorized official is Owen C Johnson .
The authorized official title is Owner and has the following contact phone number (843) 546-2244.

The CLIA number assigned to this NPI record is 42D2075411 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 9/10/2007 and was last updated on 7/9/2013.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1152W00000XOptometrist1279SOUTH CAROLINAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1P00151729OTHERSOUTH CAROLINARAILROAD MEDICARE
2U970287744MEDICARE UPINSOUTH CAROLINA
3D12791MEDICAIDSOUTH CAROLINA
45978560001MEDICARE NSCSOUTH CAROLINA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

Previous NPI
Next NPI