GEORGIA EYE INSTITUTE OF THE SOUTHEAST, LLC (NPI# 1386997013) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1386997013 |
| Entity Type | Organization |
| Organization Name | GEORGIA EYE INSTITUTE OF THE SOUTHEAST, LLC |
| Practice Address |
198 Sw Broad St Jesup GA 31545-1101 |
| Mailing Address |
198 Southwest Broad Street Jesup GA 31545-1101 |
| Practice Telephone | 9123527941 |
| Practice Fax Number | 9123527946 |
| Mailing Telephone | 9123587941 |
| Mailing Fax Number | 9123527946 |
| Enumeration Date | 2012-10-18 |
| Last Update Date | 2012-10-18 |
| Authorized Official Name | MRS. KATHY HEGAN (PRACTICE ADMINISTRATOR) |
| Authorized Official Telephone | 9126295929 |
| Is Organization Subpart | Y |
| Parent Organization Name | GEORGIA EYE INSTITUTE OF THE SOUTHEAST, LLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 152W00000X | Optometrist | Eye and Vision Services Providers | ||
| Y | 207W00000X | Ophthalmology | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124519954 | Georgia Eye Institute of The Southeast, LLC | Ophthalmology | 1000 Towne Center Blvd Ste 806, Pooler, GA 31322-4070 | 2018-05-29 |
| 1154714574 | Georgia Eye Institute of The Southeast, LLC | Optometrist | 104 Andrews Street, Suite 112, Vidalia, GA 30474 | 2015-03-10 |
| 1639410756 | Georgia Eye Institute of The Southeast, LLC | Optometrist | 741 Weeping Willow Drive, Hinesville, GA 31313 | 2013-03-14 |
| 1992058234 | Georgia Eye Institute of The Southeast, LLC | Optometrist | 3303 Glynn Avenue, Brunswick, GA 31520-4406 | 2012-10-24 |
| 1417200148 | Georgia Eye Institute of The Southeast, LLC | Ophthalmology | 80 Baylor Way, Bluffton, SC 29910-8902 | 2012-10-18 |
| 1144474016 | Georgia Eye Institute of The Southeast, LLC | Ophthalmology | 6162 Hwy 21 South, Rincon, GA 31326-5164 | 2008-11-05 |
| 1619121589 | Georgia Eye Institute of The Southeast, LLC | Ophthalmology | 2429 Us Highway 17, Richmond Hill, GA 31324-3397 | 2008-11-05 |
| 1750535621 | Georgia Eye Institute of The Southeast, LLC | Ophthalmology | 4 Okatie Center Blvd. Ste. 102, Okatie, SC 29909 | 2008-11-05 |
| 1508119207 | Georgia Eye Institute of The Southeast, LLC | Optometrist | 1000 Towne Center Blvd, Pooler, GA 31322-4052 | 2012-10-18 |
| 1275885279 | Georgia Eye Institute of The Southeast, LLC | Ophthalmology | 445 S Main St, Suite 104, Hinesville, GA 31313-4333 | 2012-10-15 |
| Street Address |
198 SW BROAD ST |
| City | JESUP |
| State | GA |
| Zip Code | 31545-1101 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427123405 | James Derryl Thomas | Optometrist | 198 Sw Broad St, Jesup, GA 31545-1101 | 2006-11-22 |
| 1114060308 | Diane Bruce | Optometrist | 198 Sw Broad St, Jesup, GA 31545-1101 | 2007-02-15 |
| 1376610618 | American Eyecare Center of Jesup Inc | Optometrist | 198 Sw Broad St, Jesup, GA 31545-1101 | 2006-11-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154922441 | Southern Pharmacy Group LLC | Pharmacy | 110 Allison St., Jesup, GA 31545 | 2020-11-04 |
| 1093350118 | Joseph Hires | Physical Therapist | 1064 N Macon St, Jesup, GA 31545 | 2019-11-13 |
| 1952866279 | Scott's Transportation of Georgia, LLC | Non-emergency Medical Transport (VAN) | 3670 Waycross Hwy, Jesup, GA 31545 | 2019-02-01 |
| 1386035335 | Shane's Crib | Substance Abuse Rehabilitation Facility | 1303 South 1st Street, Jesup, GA 31545 | 2015-02-12 |
| 1770839607 | Sandra L. Mager, M.d.p.c. | Obstetrics & Gynecology | 114 W. Cherry Street, Jesup, GA 31545 | 2012-07-30 |
| 1427318617 | Crandall Eye Physicians and Surgeons LLC | Ophthalmology | 136 W. Cherry St., Jesup, GA 31545 | 2012-05-21 |
| 1356615934 | Andrea Brooke Meeks | Assistant Behavior Analyst | 1316 W Orange St, Jesup, GA 31545 | 2012-02-29 |
| 1932419736 | Wilma R Cote | Nurse Practitioner | 391 South First St., Jesup, GA 31545 | 2010-10-14 |
| 1205144425 | Air Evac Ems Inc | Ambulance | 148 Peach Tree Street, Jesup, GA 31545 | 2010-09-22 |
| 1881911451 | Surgery Center of Bji, LLC | Clinic/Center | 112 Professional Court, Jesup, GA 31545 | 2010-04-22 |
| Find all providers in zip 31545 | ||||
| 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 |
|---|---|---|---|---|
| 1427318617 | Crandall Eye Physicians and Surgeons LLC | Ophthalmology | 136 W. Cherry St., Jesup, GA 31545 | 2012-05-21 |
| 1023266442 | Elizabeth Jane Crandall | Ophthalmology | 136 W. Cherry St, Jesup, GA 31545-0130 | 2008-08-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336748219 | Athens Eye Consultants LLC | Ophthalmology | 650 Oglethorpe Ave Ste 5, Athens, GA 30606-2216 | 2020-10-21 |
| 1922615897 | Georgia Eye Optical, LLC | Ophthalmology | 3800 Pleasant Hill Rd Ste 3, Duluth, GA 30096 | 2020-09-25 |
| 1578188306 | The Eye Md | Ophthalmology | 1359 Milstead Road, Suite #103, Conyers, GA 30012 | 2020-06-08 |
| 1255974630 | Thomas Eye Group PC | Ophthalmology | 2240 Hamilton Creek Pkwy Ste 1100, Dacula, GA 30019-4515 | 2019-10-18 |
| 1972151462 | Rahul Assa Sharma | Ophthalmology | Emory Eye Center 1365 Clifton Rd B, Atlanta, GA 30322-0001 | 2019-08-28 |
| 1821589441 | Thomas Eye Group PC | Ophthalmology | 1110 W Peachtree St Nw Ste 860, Atlanta, GA 30309-3609 | 2018-05-21 |
| 1609363878 | Patricia Anne Bentley | Ophthalmology | 4712 Polo Ln Se, Atlanta, GA 30339-5328 | 2018-04-13 |
| 1790280857 | Tift Regional Health System Inc | Ophthalmology | 1803 Old Ocilla Road, Tifton, GA 31794 | 2018-03-29 |
| 1497287031 | Luke Yuung-jier Chang | Ophthalmology | 1120 15th St # Ba2720, Augusta, GA 30912 | 2017-04-02 |
| 1689038986 | Jonathan Shader | Ophthalmology | 1120 15th St # Ba-2720, Augusta, GA 30912-3983 | 2016-04-12 |
| Find all providers with the same taxonomy | ||||
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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.