NPIMap

Myeyedr Optometry of Georgia, LLC

Organization Active NPI Optometrist · Savannah, GA

NPI 1386112167 · NPPES record last updated May 26, 2022

Key facts

NPI
1386112167
Entity type
Organization (NPI type 2)
Primary specialty
Optometrist 152W00000X
Legal business name
MYEYEDR OPTOMETRY OF GEORGIA, LLC
Practice address
7203 Hodgson Memorial Dr Ste a
Savannah, GA 31406-1525
Phone
(912) 352-9356
Fax
(912) 352-9105
NPI assigned
Nov 9, 2018
Organization subpart
No

Authorized official

Name
Sue Healey
Title
Secretary
Phone
(703) 847-8899

Corporate family (same tax ID) 42

Organizations that report the same tax identification number in the National Provider Directory.

View all 42

Medicare participation

Medicare fee-for-service enrollment
Enrolled in GA

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20140428000739 GA Part B Supplier - Clinic/Group Practice 8224261201 Receives reassigned benefits from 207 practitioners
This NPI is an additional NPI on the enrollment

National Provider Directory

Tax ID family
Myeyedr Optometry of Ga (43 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist
Group: 193400000X SINGLE SPECIALTY GROUP		 152W00000X Yes

Addresses

Primary practice location

7203 Hodgson Memorial Dr Ste a
Savannah, GA 31406-1525

Mailing address

8614 Westwood Center Dr FL 9
Vienna, VA 22182-2442
Phone (703) 847-8899

Other names

  • MyEyeDr Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on May 26, 2022.

{
    "created_epoch": "1541721600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1653523200000",
    "number": "1386112167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8614 WESTWOOD CENTER DR FL 9",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221822442",
            "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": "7203 HODGSON MEMORIAL DR STE A",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314061525",
            "telephone_number": "912-352-9356",
            "fax_number": "912-352-9105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MYEYEDR OPTOMETRY OF GEORGIA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-11-09",
        "last_updated": "2022-05-26",
        "certification_date": "2022-05-26",
        "status": "A",
        "authorized_official_last_name": "HEALEY",
        "authorized_official_first_name": "SUE",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "703-847-8899"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MyEyeDr",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "MyEyeDr",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Savannah, GA

All providers in Savannah, GA · Optometrist in Georgia

Sources for this page

Verify at the official NPI Registry.