Active NPI
South Georgia Eye Partners PC
- Ophthalmology Physician
- Tifton, GA
National Provider Identifier
1477874253
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ophthalmology Physician
- Legal business name
- SOUTH GEORGIA EYE PARTNERS PC
- Practice address
- 416 Tift Ave N
Tifton, GA 31794-4466 - Phone
- (229) 391-4180
- Fax
- (229) 391-2929
- NPI assigned
- Jun 16, 2010
- Last updated
- Feb 13, 2013
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Scott H Petermann, MD
- Title
- Owner
- Phone
- (229) 244-2068
Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.
Specialties & licenses 6
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | |||
| Corneal and Contact Management Optometrist | 152WC0802X | |||
| Pediatric Optometrist | 152WP0200X | |||
| Sports Vision Optometrist | 152WS0006X | |||
| Ophthalmology Physician | 207W00000X | Primary | ||
| Eyewear Supplier | 332H00000X |
Addresses
Primary practice location
416 Tift Ave N
Tifton, GA 31794-4466
Mailing address
4380 Kings Way
Valdosta, GA 31602-6921
Phone (229) 244-2068
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 1
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.
-
- Ophthalmology Physician
- Valdosta, GA
- NPI 1043215759
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1276646400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1360713600000",
"number": "1477874253",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4380 KINGS WAY",
"city": "VALDOSTA",
"state": "GA",
"postal_code": "316026921",
"telephone_number": "229-244-2068",
"fax_number": "229-244-2850"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "416 TIFT AVE N",
"city": "TIFTON",
"state": "GA",
"postal_code": "317944466",
"telephone_number": "229-391-4180",
"fax_number": "229-391-2929"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SOUTH GEORGIA EYE PARTNERS PC",
"organizational_subpart": "NO",
"enumeration_date": "2010-06-16",
"last_updated": "2013-02-13",
"status": "A",
"authorized_official_last_name": "PETERMANN",
"authorized_official_first_name": "SCOTT",
"authorized_official_middle_name": "H",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "229-244-2068",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
"desc": "Optometrist",
"state": null,
"license": null,
"primary": false
},
{
"code": "152WC0802X",
"taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
"desc": "Optometrist, Corneal and Contact Management",
"state": null,
"license": null,
"primary": false
},
{
"code": "152WP0200X",
"taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
"desc": "Optometrist, Pediatrics",
"state": null,
"license": null,
"primary": false
},
{
"code": "152WS0006X",
"taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
"desc": "Optometrist, Sports Vision",
"state": null,
"license": null,
"primary": false
},
{
"code": "207W00000X",
"taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
"desc": "Ophthalmology",
"state": null,
"license": null,
"primary": true
},
{
"code": "332H00000X",
"taxonomy_group": "",
"desc": "Eyewear Supplier",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Tifton, GA
- South Georgia CSB (Behavioral Health Svcs of S GA)
- South Georgia CSB (Tift C&A Outpatient Services)
- South Georgia Dermatology, PC
- South Georgia Drug Company LLC (Friendly City Pharmacy)
- South Georgia Eye Partners
- South Georgia Medicine, P.C.
- South Georgia Neurological Associates, P.C.
- South Georgia Pain Management
- South Georgia Physicians for Women
- South Georgia Surgical Clinic PC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.