Coastal Retina Institute, LLC

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

Legal business name

COASTAL RETINA INSTITUTE, LLC

Practice address

836 E 65TH St Ste 38
Savannah, GA 31405-4495

Phone

(912) 376-2030

NPI assigned

Jan 25, 2021

Organization subpart

No

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

Authorized official

Name

Laxmi Devisetty, MD

Title

Physician Owner

Phone

(312) 451-6220

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1611532800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1611532800000",
    "number": "1134719024",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 BALLASTONE CT",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314105129",
            "telephone_number": "312-451-6220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "836 E 65TH ST STE 38",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314054495",
            "telephone_number": "912-376-2030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COASTAL RETINA INSTITUTE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-01-25",
        "last_updated": "2021-01-25",
        "certification_date": "2021-01-25",
        "status": "A",
        "authorized_official_last_name": "DEVISETTY",
        "authorized_official_first_name": "LAXMI",
        "authorized_official_title_or_position": "PHYSICIAN OWNER",
        "authorized_official_telephone_number": "312-451-6220",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Ophthalmology Physician in Savannah, GA
• Providers in Savannah, GA by specialty
• Ophthalmology Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 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.