NPIMap

Organization Active NPI

Stephens County Eye Clinic,Inc

  • Optometrist
  • Toccoa, GA
National Provider Identifier
1336326503
Registry record updated Apr 30, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT001577 Issued in GA
Legal business name
STEPHENS COUNTY EYE CLINIC,INC
Practice address
1020 Big a Rd
Toccoa, GA 30577-6010
Phone
(706) 886-0111
Fax
(706) 886-7680
NPI assigned
Jan 30, 2008
Last updated
Apr 30, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2008

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

Authorized official

Name
Dr. Kevin Rick Vanderhoef, ODNPI 1033109491
Title
Owner/Doctor
Phone
(706) 886-0111

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPT001577 GA Primary

Addresses

Primary practice location

1020 Big a Rd
Toccoa, GA 30577-6010

Mailing address

1020 Big a Rd
Toccoa, GA 30577-6010
Phone (706) 886-0111

Other identifiers 2

IdentifierTypeStateIssuer
180035168OtherGARAILROAD MEDICARE
000743003DMedicaidGA

National Provider Directory

National Provider Directory

Locations

1020 Big a Rd
Toccoa, GA 30577
Phone (706) 886-0111

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 1

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": "1201651200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1209513600000",
    "number": "1336326503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1020 BIG A RD",
            "city": "TOCCOA",
            "state": "GA",
            "postal_code": "305776010",
            "telephone_number": "706-886-0111",
            "fax_number": "706-886-7680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1020 BIG A RD",
            "city": "TOCCOA",
            "state": "GA",
            "postal_code": "305776010",
            "telephone_number": "706-886-0111",
            "fax_number": "706-886-7680"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STEPHENS COUNTY EYE CLINIC,INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-30",
        "last_updated": "2008-04-30",
        "status": "A",
        "authorized_official_last_name": "VANDERHOEF",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_middle_name": "RICK",
        "authorized_official_title_or_position": "OWNER/DOCTOR",
        "authorized_official_telephone_number": "706-886-0111",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "GA",
            "license": "OPT001577",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "180035168",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000743003D",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Toccoa, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2008; 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.