Organization Active NPI

Casey N Roland, OD, PC

  • Optometrist
  • Evans, GA
National Provider Identifier
1225446701
Registry record updated Mar 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT002397 Issued in GA
Legal business name
CASEY N ROLAND, OD, PC
Practice address
4409 Evans to Locks Rd
Evans, GA 30809-3603
Phone
(706) 396-7671
Fax
(706) 228-4692
NPI assigned
Jul 28, 2014
Last updated
Mar 26, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2024

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

Authorized official

Name
Casey N Roland, ODNPI 1912105370
Title
Ceo
Phone
(706) 396-7671

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPT002397 GA Primary

Addresses

Primary practice location

4409 Evans to Locks Rd
Evans, GA 30809-3603

Mailing address

4409 Evans to Locks Rd
Evans, GA 30809-3603
Phone (706) 396-7671

Other identifiers 1

IdentifierTypeStateIssuer
286172120AMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140925000624 GA Part B Supplier - Clinic/Group Practice 8325268337 Receives reassigned benefits from 2 practitioners
Practice locations: Evans, GA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1406505600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1711411200000",
    "number": "1225446701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4409 EVANS TO LOCKS RD",
            "city": "EVANS",
            "state": "GA",
            "postal_code": "308093603",
            "telephone_number": "706-396-7671",
            "fax_number": "706-228-4692"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4409 EVANS TO LOCKS RD",
            "city": "EVANS",
            "state": "GA",
            "postal_code": "308093603",
            "telephone_number": "706-396-7671",
            "fax_number": "706-228-4692"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CASEY N ROLAND, OD, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-28",
        "last_updated": "2024-03-26",
        "certification_date": "2024-03-26",
        "status": "A",
        "authorized_official_last_name": "ROLAND",
        "authorized_official_first_name": "CASEY",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "706-396-7671",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "GA",
            "license": "OPT002397",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "286172120A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Evans, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.