Keith Milton Stillions, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPT001126 Issued in GA

Practice address

646 S 8TH St
Griffin, GA 30224-4214

Phone

(770) 228-3836

Fax

(770) 412-1733

NPI assigned

Feb 14, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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.

• Sentry Anesthesia Management, LLC

  • Anesthesiology Physician
  • Newnan, GA
  • NPI 1134544794
  NPD (past)
• Takle Eye Surgery Center LLC

  • Ambulatory Surgical Clinic/Center
  • Locust Grove, GA
  • NPI 1740776517
  NPD (past)

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

{
    "created_epoch": "1171411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615507200000",
    "number": "1104969005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "646 S 8TH ST",
            "city": "GRIFFIN",
            "state": "GA",
            "postal_code": "302244214",
            "telephone_number": "770-228-3836",
            "fax_number": "770-412-1733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "646 S 8TH ST",
            "city": "GRIFFIN",
            "state": "GA",
            "postal_code": "302244214",
            "telephone_number": "770-228-3836",
            "fax_number": "770-412-1733"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1075 Bandy Pkwy Ste 110",
            "address_purpose": "LOCATION",
            "city": "Locust Grove",
            "state": "GA",
            "postal_code": "302487036",
            "country_code": "US",
            "telephone_number": "770-228-3836",
            "fax_number": "770-412-1733",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STILLIONS",
        "first_name": "KEITH",
        "middle_name": "MILTON",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-14",
        "last_updated": "2021-03-12",
        "certification_date": "2021-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "GA",
            "license": "OPT001126",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kaylan Stanley, RBT
• Ashley Renee Stephens
• Stepping Stones Educational Therapy Center
• Rebecca Bach Stevens
• Jennifer Lashawn Stevenson, RN
• Howard Douglas Stirne, MD
• Leigh Ann Story, CNM
• Erin Stover, LAMFT
• Monica Stover, RN
• Kaylyn Strickland, APRN

• Optometrist in Griffin, GA
• Providers in Griffin, GA by specialty
• Optometrist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.