NPIMap

Organization Active NPI

Georgia Eye Institute of the Southeast, LLC

  • Ophthalmology Physician
  • Jesup, GA
National Provider Identifier
1386997013
Registry record updated Jul 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
GEORGIA EYE INSTITUTE OF THE SOUTHEAST, LLC
Practice address
198 SW Broad St
Jesup, GA 31545-1101
Phone
(912) 352-7941
Fax
(912) 352-7946
NPI assigned
Oct 18, 2012
Organization subpart
Yes
Parent organization
GEORGIA EYE INSTITUTE OF THE SOUTHEAST, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 16, 2025

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

Authorized official

Name
Erica Leigh Moreland
Title
Director, Revenue Cycle
Phone
(912) 354-4800

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193200000X MULTI-SPECIALTY GROUP 152W00000X
Ophthalmology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207W00000X Primary

Addresses

Primary practice location

198 SW Broad St
Jesup, GA 31545-1101

Mailing address

198 Southwest Broad Street
Jesup, GA 31545-1101
Phone (912) 358-7941

National Provider Directory

National Provider Directory
Tax ID family
Georgia Eye Institute9 organizations share this tax ID, including this one
Part of
Georgia Eye Institute

Other organizations with this tax ID 8

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

Locations

198 SW Broad St
Jesup, GA 31545
Phone (912) 530-6000

NPI Registry JSON

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

{
    "created_epoch": "1350518400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1752624000000",
    "number": "1386997013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "198 SOUTHWEST BROAD STREET",
            "city": "JESUP",
            "state": "GA",
            "postal_code": "315451101",
            "telephone_number": "912-358-7941",
            "fax_number": "912-352-7946"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "198 SW BROAD ST",
            "city": "JESUP",
            "state": "GA",
            "postal_code": "315451101",
            "telephone_number": "912-352-7941",
            "fax_number": "912-352-7946"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GEORGIA EYE INSTITUTE OF THE SOUTHEAST, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GEORGIA EYE INSTITUTE OF THE SOUTHEAST, LLC",
        "enumeration_date": "2012-10-18",
        "last_updated": "2025-07-16",
        "certification_date": "2025-07-16",
        "status": "A",
        "authorized_official_last_name": "MORELAND",
        "authorized_official_first_name": "ERICA",
        "authorized_official_middle_name": "LEIGH",
        "authorized_official_title_or_position": "DIRECTOR, REVENUE CYCLE",
        "authorized_official_telephone_number": "912-354-4800"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jesup, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2025; 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.