GEORGIA EYE INSTITUTE OF THE SOUTHEAST, LLC (NPI# 1619121589) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619121589 |
| Entity Type | Organization |
| Organization Name | GEORGIA EYE INSTITUTE OF THE SOUTHEAST, LLC |
| Practice Address |
2429 Us Highway 17 Richmond Hill GA 31324-3397 |
| Mailing Address |
4720 Waters Ave Savannah GA 31404-6292 |
| Practice Telephone | 9127566091 |
| Practice Fax Number | 9127566098 |
| Mailing Telephone | 9123544800 |
| Mailing Fax Number | 9126295821 |
| Enumeration Date | 2008-11-05 |
| Last Update Date | 2012-10-15 |
| Authorized Official Name | MRS. KATHY HEGAN (PRACTICE ADMINISTRATOR) |
| Authorized Official Telephone | 9126295929 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207W00000X | Ophthalmology | Allopathic & Osteopathic Physicians | ||
| Y | 152W00000X | Optometrist | Eye and Vision Services Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SC | MEDICAID MD | GPA977 | 01 |
| SC | MEDICAID OD | DAG976 | 01 |
| 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 |
| 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 |
| 1386997013 | Georgia Eye Institute of The Southeast, LLC | Optometrist | 198 Sw Broad St, Jesup, GA 31545-1101 | 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 |
2429 US HIGHWAY 17 |
| City | RICHMOND HILL |
| State | GA |
| Zip Code | 31324-3397 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902389588 | Bryan Anderson | Physician Assistant | 8435 Vanguard Road, Fort Stewart, GA 31324 | 2018-09-10 |
| 1366941684 | Codie Wiley | Physician Assistant | Expercare Urgent Care 60 Exchange Street, Suite B7, Richmond Hill, GA 31324 | 2018-02-02 |
| 1174038145 | Shelly Stewart Childers | Nurse Practitioner | 2453 U.S. 17, Suite G, Richmond Hill, GA 31324 | 2017-12-12 |
| 1619495215 | Kristi Oxley | Nurse Practitioner | 2701 Us Hwy 17 Ste 1b, Richmond Hill, GA 31324 | 2017-09-03 |
| 1275062564 | Janice Tillman Gravitt | Registered Nurse | 60 Long Creek Lane, Richmond Hill, GA 31324 | 2017-06-08 |
| 1336680065 | Choice Care Medical | Durable Medical Equipment & Medical Supplies | 9390 Ford Ave Ste 9, Richmond Hill, GA 31324 | 2017-03-14 |
| 1750730263 | Haralabos Saltourides | Physical Therapy Assistant | 127 Carter Street, Richmond Hill, GA 31324 | 2016-06-06 |
| 1922462464 | Leia Edenfield | Student in an Organized Health Care Education/Training Program | 105 Balfour Dr, Richmond Hill, GA 31324 | 2016-04-11 |
| 1477931384 | Stephanie Eileen Banasik | Nurse Practitioner | 10200 Ford Ave. Ste. 101, Richmond Hill, GA 31324 | 2015-05-12 |
| 1962800771 | Kendra Seagraves | Nurse Practitioner | 9976 Ford Avenue, Richmond Hill, GA 31324 | 2014-12-10 |
| Find all providers in zip 31324 | ||||
| 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 |
|---|---|---|---|---|
| 1063883114 | Oksana Aykelinchayev | Optometrist | 8545 111th St, Richmond Hill, NY 11418-1638 | 2015-10-15 |
| 1598160152 | Bayside Family Vision Corp | Optometrist | 10425 Jamaica Ave, Richmond Hill, NY 11418-2012 | 2014-10-24 |
| 1417268814 | Dylan Joseph Olivos | Optometrist | 11621 Jamaica Ave, Richmond Hill, NY 11418-2433 | 2010-06-30 |
| 1922237999 | Jennifer Alyse Ferri | Optometrist | 11915 Atlantic Ave, Richmond Hill, NY 11418-3216 | 2009-07-10 |
| 1407918139 | George Grant | Optometrist | 180 Mingarry Dr, Richmond Hill, GA 31324-5121 | 2006-12-16 |
| 1750494852 | Veranika Sherman | Optometrist | 115-02 Liberty Ave, Lensmasters, Richmond Hill, NY 11419 | 2006-08-16 |
| 1811925977 | Habesham Eye Clinic Inc | Optometrist | 35 Parker Ln, Richmond Hill, GA 31324-3695 | 2006-06-29 |
| 1811595291 | Cledis V Ramirez-reyes | Optometrist | 11915 Atlantic Ave, Richmond Hill, NY 11418-3216 | 2020-10-16 |
| 1790309623 | Olivos Optometry PC | Optometrist | 11615 Jamaica Ave, Richmond Hill, NY 11418-2433 | 2020-06-06 |
| 1851953566 | John Lawrence Pagano | Optometrist | 11915 Atlantic Ave, Richmond Hill, NY 11418-3216 | 2019-07-02 |
| Find all providers in RICHMOND HILL | ||||
| City | RICHMOND HILL |
| Zip Code | 31324 |
Please comment or provide details below to improve the information on GEORGIA EYE INSTITUTE OF THE SOUTHEAST, LLC.
| 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.