Kimberly Sue Anderson, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

2006 Issued in GA

Practice address

361 Highway 74 N
Peachtree City, GA 30269-1102

Phone

(770) 487-0667

NPI assigned

Nov 6, 2008

Last updated

Nov 5, 2021By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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

Specialty

Optometry

Education

Illinois College of Optometry at Chicago, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

John L. Henahan, OD, PocGroup PAC ID 7911076831, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kim@speceye.emadirect.md

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

• John L. Henahan, OD, Poc

  dba Spectrum Eyecare

  • Optometrist
  • Peachtree City, GA
  • NPI 1013188952
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1225929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636070400000",
    "number": "1144474941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 RIVERBIRCH WAY",
            "city": "SHARPSBURG",
            "state": "GA",
            "postal_code": "302775219",
            "telephone_number": "770-330-0925"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "361 HIGHWAY 74 N",
            "city": "PEACHTREE CITY",
            "state": "GA",
            "postal_code": "302691102",
            "telephone_number": "770-487-0667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "KIMBERLY",
        "middle_name": "SUE",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-11-06",
        "last_updated": "2021-11-05",
        "certification_date": "2021-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "GA",
            "license": "2006",
            "primary": true
        },
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "GA",
            "license": "2006",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David Lloyd Anders, M.D.
• Bruce William Anderson, D.D.S.
• Dionne Anderson, DC
• Jaycee Anderson
• John Benjamin Anderson, DPT
• Paul Edward Anderson Jr., MD, DMD
• Andreone Sports & Family Chiropractic
• Christopher P. Andreone, D.C.
• Anesthesia Plus LLC
• Angel Pain Relief Center

• Optometrist in Peachtree City, GA
• Providers in Peachtree City, GA by specialty
• Optometrist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.