Fitzgerald Family Eyecare, P.C.

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPT002104 Issued in GA

Legal business name

FITZGERALD FAMILY EYECARE, P.C.

Practice address

1329 Ocilla Rd
Douglas, GA 31533-2213

Phone

(912) 393-0005

Fax

(912) 393-0058

NPI assigned

Aug 10, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Ellen Drury Fitzgerald, O.D.NPI 1629089222

Title

President

Phone

(912) 393-0005

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Interoperability endpoints

• Direct secure messaging: ellen.fitzgerald@ffeyecare.eyefinity-direct.com

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Ellen Drury Fitzgerald, O.D.

  • Optometrist
  • Douglas, GA
  • NPI 1629089222
  Medicare reassignment NPD Authorized official
• Kenneth Trevor Shealy, O.D.

  • Optometrist
  • Tifton, GA
  • NPI 1104436922
  Medicare reassignment NPD

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

{
    "created_epoch": "1155168000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1659052800000",
    "number": "1114938727",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1329 OCILLA RD",
            "city": "DOUGLAS",
            "state": "GA",
            "postal_code": "315332213",
            "telephone_number": "912-393-0005",
            "fax_number": "912-393-0058"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1329 OCILLA RD",
            "city": "DOUGLAS",
            "state": "GA",
            "postal_code": "315332213",
            "telephone_number": "912-393-0005",
            "fax_number": "912-393-0058"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FITZGERALD FAMILY EYECARE, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-10",
        "last_updated": "2022-07-29",
        "certification_date": "2022-07-29",
        "status": "A",
        "authorized_official_last_name": "FITZGERALD",
        "authorized_official_first_name": "ELLEN",
        "authorized_official_middle_name": "DRURY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "912-393-0005",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "GA",
            "license": "OPT002104",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "535526348B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Justin Marcus Fender, R-NP
• Kelsea Renea Fender, FNP
• Sarah Allyson Fender
• Shamika Lashonda Fernandez
• Joel W Ferree, MD
• Ellen Drury Fitzgerald, O.D.
• Michael S. Flory, APRN
• Tequoria Flowers
• Susan Ivey Fortner, M.ED., CF/SLP
• Syria Frost

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.