Individual provider Active NPI

Edward D Sammons, OD

  • Optometrist
  • Savannah, GA
National Provider Identifier
1104847425
Registry record updated Aug 27, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT002183 Issued in GA
Practice address
2 E Jackson Blvd
Savannah, GA 31405-5810
Phone
(912) 352-7941
Fax
(912) 352-7946
NPI assigned
Jul 21, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPT002183 GA Primary

Addresses

Primary practice location

2 E Jackson Blvd
Savannah, GA 31405-5810

Mailing address

2 E Jackson Blvd
Savannah, GA 31405-5810
Phone (912) 352-7941

Other identifiers 1

IdentifierTypeStateIssuer
880346501AMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040825000866 GA Practitioner - Optometry 2264406123 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Privia Medical Group of Georgia LLCGroup PAC ID 4284951542, 454 clinicians
360Care Services of Georgia LLCGroup PAC ID 5991145112, 7 clinicians

Practice addresses (Care Compare)

101 Yorktown Dr
Fayetteville, GA 30214-1578

101 Yorktown Dr
Suite 100
Fayetteville, GA 30214-7663
Phone (770) 460-4285

1326 Eisenhower Dr
Savannah, GA 31406-3928

40 Technology Pkwy S
Norcross, GA 30092-2987
Phone (248) 528-2116

455 S Main St
Hinesville, GA 31313-4354

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPT002183GAMDOptometrist
1319SCMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Privia Medical Group of Georgia LLC CurrentSince May 1, 2019 Accepting new patients
Mobile Medical Eye Care LLC Optometrist CurrentSince Nov 22, 2022 Accepting new patients
360Care Services of Georgia LLC Optometrist CurrentSince Mar 27, 2024 Accepting new patients
Privia Medical Group of Georgia LLC CurrentSince May 1, 2019 Accepting new patients
Ophthalmology Associates Past Accepting new patients
LTC Eyecare Inc Optometrist PastSince Jul 19, 2010 Accepting new patients
Georgia Eye Institute of the Southeast, LLC Optometrist Past Accepting new patients

Locations

101 Yorktown Dr
Ste 100
Fayetteville, GA 30214
Phone (770) 460-4285

455 S Main St
Ste 201
Hinesville, GA 31313
Phone (912) 877-6781

455 S Main St
Ste 102
Hinesville, GA 31313
Phone (912) 876-5505

1326 Eisenhower Dr
#1
Savannah, GA 31406
Phone (912) 691-4100

1326 Eisenhower Dr
Bldg 1
Savannah, GA 31406
Phone (912) 691-4100

12910 Shelbyville Rd
Ste 128
Louisville, KY 40243

4350 Brownsboro Rd
Ste 210
Louisville, KY 40207
Phone (830) 212-1661

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/8042/brand/1/csg/1/fhir/r4
  • Direct secure messaging: edward.sammons.1@8042.direct.athenahealth.com
  • Direct secure messaging: edwardsammons@scmgllc.allscriptsdirect.net

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1153440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346025600000",
    "number": "1104847425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 E JACKSON BLVD",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314055810",
            "telephone_number": "912-352-7941",
            "fax_number": "912-352-7946"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 E JACKSON BLVD",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314055810",
            "telephone_number": "912-352-7941",
            "fax_number": "912-352-7946"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMMONS",
        "first_name": "EDWARD",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-21",
        "last_updated": "2012-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "GA",
            "license": "OPT002183",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "880346501A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Savannah, GA

Sources for this page

Verify at the official NPI Registry.