Individual provider Active NPI

Renee Elizabeth Williams, O.D.

  • Optometrist
  • Brunswick, GA
National Provider Identifier
1184604191
Registry record updated Jul 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT002279 Issued in GA
Practice address
4875 Altama Ave
Brunswick, GA 31520-2912
Phone
(912) 554-0010
Fax
(912) 554-0075
NPI assigned
Jan 18, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 8123-T TX
Optometrist 152W00000X OPT002279 GA Primary

Addresses

Primary practice location

4875 Altama Ave
Brunswick, GA 31520-2912

Mailing address

400 S Loop 336 W
Conroe, TX 77304-3302
Phone (936) 539-4500

Other practice location 1

1326 Eisenhower Dr
BLDG 1
Savannah, GA 31406-3928
Phone (912) 691-4100

Other identifiers 3

IdentifierTypeStateIssuer
786573174BMedicaidGA
786573174AMedicaidGA
P00294702OtherGARR MEDICARE

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
I20060314000283 GA Practitioner - Optometry 0244210086 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Low Country Eye Associates, PCGroup PAC ID 8729984786, 8 clinicians

Practice addresses (Care Compare)

1000 Gandy Dancer
Richmond Hill, GA 31324-7400
Phone (912) 756-3628

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

LicenseStateTypeSpecialty
8123-TTXMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Myeyedr Optometry of Georgia, LLC Optometrist Current Accepting new patients
Myeyedr Optometry of Georgia, LLC Optometrist CurrentSince Aug 8, 2022 Accepting new patients
Myeyedr Optometry of Georgia, LLC Optometrist CurrentSince Aug 8, 2022 Accepting new patients
Low Country Eye Associates, PC Optometrist CurrentSince Apr 9, 2024 Accepting new patients

Locations

4875 Altama Ave
Brunswick, GA 31520
Phone (912) 554-0010

465 Elma G Miles Pkwy
Hinesville, GA 31313
Phone (912) 877-2422

2003 Commerce Dr
Kingsland, GA 31548
Phone (912) 882-3040

1000 Towne Center Blvd
Ste 502
Pooler, GA 31322
Phone (912) 748-1272

1000 Gandy Dancer
Richmond Hill, GA 31324
Phone (912) 712-0132

8614 Westwood Center Dr
Fl 9
Vienna, VA 22182

Organizations & group practices 4

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": "1137542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658793600000",
    "number": "1184604191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 S LOOP 336 W",
            "city": "CONROE",
            "state": "TX",
            "postal_code": "773043302",
            "telephone_number": "936-539-4500",
            "fax_number": "936-539-4050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4875 ALTAMA AVE",
            "city": "BRUNSWICK",
            "state": "GA",
            "postal_code": "315202912",
            "telephone_number": "912-554-0010",
            "fax_number": "912-554-0075"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1326 Eisenhower Dr",
            "address_2": "BLDG 1",
            "address_purpose": "LOCATION",
            "city": "Savannah",
            "state": "GA",
            "postal_code": "314063928",
            "country_code": "US",
            "telephone_number": "912-691-4100",
            "fax_number": "912-691-4289",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "RENEE",
        "middle_name": "ELIZABETH",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-18",
        "last_updated": "2022-07-26",
        "certification_date": "2022-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "8123-T",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "GA",
            "license": "OPT002279",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "786573174B",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "786573174A",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00294702",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brunswick, GA

Sources for this page

Verify at the official NPI Registry.