Individual provider Active NPI

John Trafton Fleetwood, Jr., O.D.

  • Optometrist
  • Savannah, GA
National Provider Identifier
1457445116
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT000929 Issued in GA
Practice address
Savannah Mall
7400 Abercorn Ste 807-809
Savannah, GA 31419-1957
Phone
(912) 352-0600
Fax
(912) 355-1886
NPI assigned
Oct 3, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPT000929 GA Primary

Addresses

Primary practice location

Savannah Mall
7400 Abercorn Ste 807-809
Savannah, GA 31419-1957

Mailing address

244 E 64TH St
Savannah, GA 31405-5305
Phone (912) 691-0459

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
OPT000929GAMDOptometrist

NPI Registry JSON

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1457445116",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "244 E 64TH ST",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314055305",
            "telephone_number": "912-691-0459",
            "fax_number": "912-355-1886"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "SAVANNAH MALL",
            "address_2": "7400 ABERCORN STE 807-809",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314191957",
            "telephone_number": "912-352-0600",
            "fax_number": "912-355-1886"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLEETWOOD, JR.",
        "first_name": "JOHN",
        "middle_name": "TRAFTON",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "GA",
            "license": "OPT000929",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Savannah, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.