Benjamin Johnson Crider, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPT003372 Issued in GA

Practice address

105 Grand Central Blvd Ste 110
Pooler, GA 31322-4148

Phone

(912) 450-9200

Fax

(912) 450-9201

NPI assigned

Jun 11, 2013

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IN, GA, SC3 enrollments

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 3

Specialty

Optometry

Education

Indiana University - School of Optometry, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Myeyedr Optometry of Georgia, LLCGroup PAC ID 8224261201, 100 clinicians

Myeyedr Optometry of South Carolina, LLCGroup PAC ID 3173741618, 24 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Myeyedr Optometry of Georgia, LLC

  • Optometrist
  • Rincon, GA
  • NPI 1437294592
  Medicare reassignment Care Compare group NPD
• Myeyedr Optometry of South Carolina, LLC

  • Optometrist
  • Rock Hill, SC
  • NPI 1205248481
  Medicare reassignment Care Compare group NPD
• Myeyedr Optometry of Indiana, LLC

  • Optometrist
  • Lebanon, IN
  • NPI 1083100424
  Medicare reassignment NPD
• Myeyedr Optometry of Georgia, LLC

  • Optometrist
  • Tyrone, GA
  • NPI 1275326571
  NPD
• Myeyedr Optometry of Georgia, LLC

  • Optometrist
  • Pooler, GA
  • NPI 1760883904
  NPD
• Myeyedr Optometry of Indiana, LLC

  • Optometrist
  • Camby, IN
  • NPI 1174019566
  NPD
• Myeyedr Optometry of Indiana, LLC

  • Optometrist
  • Munster, IN
  • NPI 1922974526
  NPD
• Myeyedr Optometry of South Carolina, LLC

  • Optometrist
  • Indian Land, SC
  • NPI 1093679961
  NPD
• Myeyedr Optometry of South Carolina, LLC

  • Optometrist
  • Beaufort, SC
  • NPI 1326600263
  NPD
• Myeyedr Optometry of Georgia, LLC

  • Optometrist
  • Woodstock, GA
  • NPI 1144684184
  NPD (past)
• Eyecare Indiana II, P.C.

  • Optometrist
  • Indianapolis, IN
  • NPI 1407134950
  NPD (past)

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

{
    "created_epoch": "1370908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632700800000",
    "number": "1215375480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1950 OLD GALLOWS RD STE 520",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221823970",
            "telephone_number": "703-847-8899",
            "fax_number": "571-223-6780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 GRAND CENTRAL BLVD STE 110",
            "city": "POOLER",
            "state": "GA",
            "postal_code": "313224148",
            "telephone_number": "912-450-9200",
            "fax_number": "912-450-9201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRIDER",
        "first_name": "BENJAMIN",
        "middle_name": "JOHNSON",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-06-11",
        "last_updated": "2021-09-27",
        "certification_date": "2021-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "GA",
            "license": "OPT003372",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000831910",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 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.