Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

JEVAUGHN GIBBS OD
NPI 1124817218
Optometrist in Myrtle Beach, SC

Q: What is Jevaughn Gibbs's NPI number?

The NPI number for Jevaughn Gibbs is 1124817218. It was assigned to this individual provider in the NPPES registry on May 5, 2025.

Q: What is Jevaughn Gibbs's specialty?

The primary specialty registered for this NPI is Optometrist with taxonomy code 152W00000X.

Q: When was this NPI record last updated?

The NPPES record for Jevaughn Gibbs was last updated on June 23, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 53 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since May 05, 2025PECOS EnrolledAccepts Medicare Assignment

109 FINNEGAN CT, MYRTLE BEACH, SC 29579(843) 903-0949 Get Directions Write a Review

NPPES record last updated: June 23, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jul 9, 2025, May 5, 2025 (2 updates tracked since 2025).

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About Jevaughn Gibbs Od NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JEVAUGHN GIBBS OD (NPI 1124817218) is an individual optometrist in Myrtle Beach, South Carolina, licensed in Georgia (OPT003727) and active in the NPI registry since May 2025. He is enrolled in Medicare PECOS, maintains a secondary practice location in Lithonia, and is a graduate of Illinois College Of Optometry At Chicago (2025).

NPPES Registry Identity

NPI1124817218

Entity TypeIndividualMale

Primary Taxonomy152W00000X

Provider Legal NameJEVAUGHN GIBBSCredential: OD

Location Address109 FINNEGAN CTMyrtle Beach, SC 29579-4205

Mailing Address109 Finnegan CtMyrtle Beach, SC 29579-4205 · (843) 903-0949

Phone(843) 903-0949

Sole ProprietorNo

Medical School CMSIllinois College Of Optometry At ChicagoGraduated 2025

Enumeration DateMay 5, 2025

Last NPPES UpdateJune 23, 20262 updates tracked since enumeration

NPPES CertifiedJune 23, 2026

✔ NPI 1124817218 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOptometristEye and Vision Services Providers

Taxonomy Code152W00000X

Licenses✔ Licensed in GA · OPT003727✔ Licensed in CO · OPT.0004171✔ Licensed in SC · 2549

Definition

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.

109 FINNEGAN CT, Myrtle Beach, SC 29579

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Secondary Practice Location 1

Location 18075 Mall Pkwy Ste 103Lithonia, GA 30038-6993 · Phone (770) 484-2955

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma, Blue Cross and Blue Shield of Texas and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Jevaughn Gibbs Od is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID6103320304

PECOS Enrollment IDI20250919002473

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 29579 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$124.04 typical visit price

range $53.57 – $163.84

Typical copayment $31.01 (range $13.39 – $40.96)

Most-billed visit code 99204

Established Patient

$67.12 typical visit price

range $16.96 – $133.52

Typical copayment $16.78 (range $4.24 – $33.38)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. TAMMY T TULLY O.D.

Optometrist

109 FINNEGAN CT
MYRTLE BEACH, SC 29579

Horry County (843) 903-0949

SEASIDE EYE ASSOCIATES P A

Optometrist

109 FINNEGAN CT
MYRTLE BEACH, SC 29579

Horry County (843) 903-0949

DR. AMANDA K LEE O.D.

Optometrist

109 FINNEGAN CT
MYRTLE BEACH, SC 29579

Horry County (843) 903-0949

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jevaughn Gibbs's NPI number?

The NPI number for Jevaughn Gibbs is 1124817218. It was assigned to this individual provider in the NPPES registry on May 5, 2025.

Where is Jevaughn Gibbs located?

Jevaughn Gibbs practices at 109 Finnegan Ct, Myrtle Beach, SC 29579. The listed phone number is (843) 903-0949.

What is Jevaughn Gibbs's specialty?

The primary specialty registered for this NPI is Optometrist with taxonomy code 152W00000X.

Is Jevaughn Gibbs enrolled in Medicare?

Yes. Jevaughn Gibbs is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Jevaughn Gibbs accept?

Health plans from Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma, Blue Cross and Blue Shield of Texas and Providence Health Plan list Jevaughn Gibbs as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Jevaughn Gibbs was last updated on June 23, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 53 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.