Premier Vision Partners

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

PREMIER VISION PARTNERS

Practice address

5391 Highway 53 Ste 102
Braselton, GA 30517-3136

Phone

(706) 658-0270

NPI assigned

Sep 14, 2021

Last updated

Sep 14, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Darrell Sorah, ODNPI 1679577258

Title

Owner/Optometrist

Phone

(706) 658-0270

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Winder Eye Care Center

  • Optometrist
  • Winder, GA
  • NPI 1154349041

  Member Of

  NPD member

Locations

Practitioners 6

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.

• Kelly Heren, O.D.

  • Optometrist
  • Winder, GA
  • NPI 1740630466
  Medicare reassignment Care Compare group NPD
• Jennifer G. Slotwinski, O.D.

  • Optometrist
  • Gainesville, GA
  • NPI 1639325780
  Medicare reassignment Care Compare group NPD
• Darrell Allen Sorah Jr., OD

  • Optometrist
  • Winder, GA
  • NPI 1679577258
  Medicare reassignment NPD Authorized official
• Sean Francis Pinard, OD

  • Optometrist
  • Newport, VT
  • NPI 1891224069

  GA

  Medicare reassignment Care Compare group NPD
• Karen M Canupp, OD

  • Optometrist
  • Winder, GA
  • NPI 1346211679
  Medicare reassignment NPD
• Staci Harwell Tebbetts, OD

  • Optometrist
  • Dawsonville, GA
  • NPI 1417485715
  Medicare reassignment NPD

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

{
    "created_epoch": "1631577600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1631577600000",
    "number": "1376213165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "279 N BROAD ST STE C",
            "city": "WINDER",
            "state": "GA",
            "postal_code": "306802589",
            "telephone_number": "770-867-2505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5391 HIGHWAY 53 STE 102",
            "city": "BRASELTON",
            "state": "GA",
            "postal_code": "305173136",
            "telephone_number": "706-658-0270"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER VISION PARTNERS",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-09-14",
        "last_updated": "2021-09-14",
        "certification_date": "2021-09-14",
        "status": "A",
        "authorized_official_last_name": "SORAH",
        "authorized_official_first_name": "DARRELL",
        "authorized_official_title_or_position": "OWNER/OPTOMETRIST",
        "authorized_official_telephone_number": "706-658-0270",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2021; 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.