Ashley Ayn Fortney, O.D.
Individual provider Active NPI Optometrist · Eastanollee, GA
NPI 1003042888 · NPPES record last updated Jul 14, 2009
Key facts
- NPI
- 1003042888
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Optometrist 152W00000X
- License
- 2465 (GA)
- Practice address
- 3886 Ga Highway 17 Rd
Eastanollee, GA 30538-3808 - Phone
- (706) 297-7292
- NPI assigned
- Jun 6, 2009
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Optometry
- Education
- Southern College of Optometry, 2008
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
3886 Ga Hwy 17
Eastonollee, GA 30538-3811
Phone (706) 297-7292
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Cataract surgery | 1-10 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in GA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20091008000054 | GA | Practitioner - Optometry | 0749326502 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2810 | TN | MD | Mental Health Counselor |
| 2465 | GA | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fortney Eye Care, LLC | Optometrist | Current |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 2465 | GA | Yes |
| Optometrist | 152W00000X | 2810 | TN |
Addresses
Primary practice location
3886 Ga Highway 17 Rd
Eastanollee, GA 30538-3808
Mailing address
PO Box 1730
Dacula, GA 30019-0030
Phone (901) 409-2901
Other providers in Eastanollee, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 14, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.