Distinctive Eyewear Vision Center
NPI 1174806053ActiveOrganization· Optometrist· Myrtle Beach, SC
Optometrist in Myrtle Beach, South Carolina, registered in NPPES in September 2011. The authorized official on file is Lauri Baldwin Graham, O.D., Owner. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1174806053 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Sep 27, 2011 |
| Last updated in NPPES | Sep 27, 2011 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Optometrist Primary | 152W00000X | 1396 | SC |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 4, 2026 | No match | — |
| New York OMIG · Nov 4, 2026 | No match | — |
| Ohio Medicaid · Nov 4, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 4, 2026 | No match | — |
| Washington HCA · Nov 4, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (SC) |
|---|
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