Kerry Ronald Freeman, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

001490 Issued in GA

Practice address

6162 Ga Highway 21 S
Rincon, GA 31326-5507

Phone

(912) 826-3949

Fax

(888) 810-2083

NPI assigned

Jun 6, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Effingham Eye Care

  • Optometrist
  • Rincon, GA
  • NPI 1275675068
  Medicare reassignment NPD

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

{
    "created_epoch": "1149552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1326672000000",
    "number": "1477592046",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6162 GA HIGHWAY 21 S",
            "city": "RINCON",
            "state": "GA",
            "postal_code": "313265507",
            "telephone_number": "912-826-3949",
            "fax_number": "888-810-2083"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6162 GA HIGHWAY 21 S",
            "city": "RINCON",
            "state": "GA",
            "postal_code": "313265507",
            "telephone_number": "912-826-3949",
            "fax_number": "888-810-2083"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREEMAN",
        "first_name": "KERRY",
        "middle_name": "RONALD",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-06",
        "last_updated": "2012-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "GA",
            "license": "001490",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000788576B",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "488752",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Anthony Matthew Foley Sr., M.D.
• Brittany James Ford, FNP
• Fran Speer Counseling Inc
• Samuel Freed, DMD
• Caroline Freeman
• Sarah Brodhead Freeman, O.D.
• Jennifer Fuqua, MSW
• Laura Gash
• Sarai M George
• Georgia CVS Pharmacy LLC

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.