DR. NICHOLAS R. BOLLIN (NPI# 1003831371) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003831371 |
| Entity Type | Individual |
| Full Name | DR. NICHOLAS R. BOLLIN |
| Credential | OD |
| Practice Address |
4720 Waters Ave Savannah GA 31404-6292 |
| Practice Telephone | 9123544800 |
| Practice Fax Number | 9126295821 |
| Mailing Telephone | 9123544800 |
| Mailing Fax Number | 9126295821 |
| Enumeration Date | 2006-07-13 |
| Last Update Date | 2019-02-12 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 152W00000X | Optometrist | 1463 | SC | Eye and Vision Services Providers |
| Y | 152W00000X | Optometrist | OPT002419 | GA | Eye and Vision Services Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | MEDICARE GROUP | 511G701032 | 01 |
| SC | MEDICAID GROUP NUMBER | DA9680 | 01 |
| GA | MEDICARE PTAN | 511I410154 | 01 |
| SC | MEDICARE GROUP NUMBER | 6830 | 01 |
| GA | 895091476F | 05 | |
| SC | D14633 | 05 | |
| SC | MEDICARE PTAN | AA62946830 | 01 |
| GA | RAILROAD MEDICARE PTAN | P00684230 | 01 |
| GA | 895091476D | 05 |
| Street Address |
4720 WATERS AVE |
| City | SAVANNAH |
| State | GA |
| Zip Code | 31404-6292 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083617419 | Shari Carney | Ophthalmology | 4720 Waters Ave, Savannah, GA 31404 | 2005-05-31 |
| 1366734147 | Thomas J Kandl | Ophthalmology | 4720 Waters Ave, Savannah, GA 31404-6292 | 2011-05-11 |
| 1356575377 | Georgia Eye Institute Surgery Center LLC | Clinic/Center | 4720 Waters Ave, Savannah, GA 31404-6292 | 2009-05-05 |
| 1700039740 | Georgia Eye Institute of The Southeast, LLC | Optometrist | 4720 Waters Ave, Savannah, GA 31404-6292 | 2008-11-03 |
| 1306006226 | Robin Ray | Ophthalmology | 4720 Waters Ave, Savannah, GA 31404-6292 | 2008-06-13 |
| 1508058181 | Memorial Health University Medical Center | General Acute Care Hospital | 4720 Waters Ave, Savannah, GA 31404-6292 | 2007-08-16 |
| 1740487131 | Jennifer Goodrich Bromley | Ophthalmology | 4720 Waters Ave, Savannah, GA 31404-6292 | 2007-06-28 |
| 1952323990 | Georgia Eye Institute, Inc. | Optometrist | 4720 Waters Ave, Savannah, GA 31404-6292 | 2006-07-25 |
| 1437198983 | Joseph R Gussler | Ophthalmology | 4720 Waters Ave, Savannah, GA 31404-6292 | 2006-06-06 |
| 1508805052 | David D Kim | Ophthalmology | 4720 Waters Ave, Savannah, GA 31404-6292 | 2006-06-06 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043864580 | Carli A Boatright | Registered Nurse | 4750 Waters Ave Suite 206, Savannah, GA 31404 | 2019-08-01 |
| 1619530573 | Morgan Johnson | Student in an Organized Health Care Education/Training Program | Memorial Health University Medical Center, 4700 Waters Ave, Savannah, GA 31404 | 2019-04-17 |
| 1477050243 | Kevin Timperman | Student in an Organized Health Care Education/Training Program | 4700 Waters Avenus, Surgery Residency Program, Mhumc, Savannah, GA 31404 | 2018-04-09 |
| 1376048959 | Nina Jo Paletta | Student in an Organized Health Care Education/Training Program | Memorial University Medical Center, 4700 Waters Ave., Savannah, GA 31404 | 2018-03-27 |
| 1972036200 | Jose Adrian Lara Gonzalez | Student in an Organized Health Care Education/Training Program | 4700 Waters Ave, Memorial University Medical Center, Internal Medicine Residency Program, Savannah, GA 31404 | 2017-04-04 |
| 1407210396 | Lexie Hester Vaughn | Student in an Organized Health Care Education/Training Program | 1250 East 66th St, Savannah, GA 31404 | 2016-04-07 |
| 1336503291 | Miles Love | Student in an Organized Health Care Education/Training Program | 1250 East 66th Street, Savannah, GA 31404 | 2016-04-07 |
| 1134536881 | David Patch | Specialist/Technologist | Pediatric Residency Program, Memorial University, Medical Center 4700 Waters Avenue, Savannah, GA 31404 | 2014-07-15 |
| 1962846683 | Alan Danilo Zevallos | Internal Medicine | 4700 Waters Avenue, University Medical Center, Internal Medicine Residency Program, Memorial Health, Savannah, GA 31404 | 2013-04-24 |
| 1730446394 | Joshua Ryan Fann | Prosthetist | 3840 Waters Ave, Savannah, GA 31404 | 2012-04-19 |
| Find all providers in zip 31404 | ||||
| Taxonomy Code | 152W00000X |
| Grouping | Eye and Vision Services Providers |
| Classification | Optometrist |
| 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. |
| Notes: Source: American Optometric Association (AOA), approved by the AOA’s Board of Trustees, June 21, 2005. [7/1/2006: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386112167 | Myeyedr Optometry of Georgia, LLC | Optometrist | 7203 Hodgson Memorial Dr Ste A, Savannah, GA 31406-1525 | 2018-11-09 |
| 1659813756 | Nikita Desai | Optometrist | 318 Mall Blvd # 600, Savannah, GA 31406-4797 | 2016-11-07 |
| 1265881627 | Erika Marie Morrow | Optometrist | 350 Martin Luther King Jr Blvd, Savannah, GA 31401-4386 | 2016-06-07 |
| 1659779130 | Daniel, Max & Marcandrea, LLC | Optometrist | 6868 Abercorn St, Savannah, GA 31405-5835 | 2014-12-15 |
| 1811328123 | Jay Jackson Od PC | Optometrist | 5500 Abercorn St Ste 24, 12 Oaks Shopping Center, Savannah, GA 31405-6917 | 2013-12-12 |
| 1427359959 | Coastal Georgia Eyecare, LLC | Optometrist | 1 Diamond Cswy, Suite 21, Savannah, GA 31406-7417 | 2010-11-15 |
| 1598934911 | Lewis Steinfeld | Optometrist | 101 W. Broughton Street, Savannah, GA 31401-3211 | 2008-02-29 |
| 1861619660 | Wm Brent Walker | Optometrist | 3 River Walk, Savannah, GA 31410-1563 | 2007-04-20 |
| 1164549366 | Myeyedr Optometry of Georgia, LLC | Optometrist | 14045 Abercorn St Ste 31, Savannah Mall, Savannah, GA 31419-1978 | 2007-03-23 |
| 1831233279 | Nancy Elizabeth Gresham | Optometrist | 7810 Abercorn St, Sears Optical, Savannah, GA 31406-2440 | 2007-02-19 |
| Find all providers in SAVANNAH | ||||
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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.