Eyeassociates Surgery Center, Inc

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

EYEASSOCIATES SURGERY CENTER, INC

Practice address

3024 N Patterson St
Valdosta, GA 31602-1711

Phone

(229) 247-4114

Fax

(229) 245-9042

NPI assigned

Mar 1, 2007

Organization subpart

No

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

Authorized official

Name

Nicole Sinclair, RN

Title

Manager

Phone

(229) 247-4114

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Ambulatory surgical center certification: CCN 11C0001153

Legal name

EYE ASSOCIATES SURGERY CTR

Certification status

Active

Provider type (POS)

Ambulatory surgical center

Participating since

Sep 1, 1999

Last certification

Jul 18, 2019

Ownership / control type

Proprietary

Facility address

3024 N. Patterson St.
Valdosta, GA 31602

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Albert Gonzalez-Acevedo, M.D.

  • Ophthalmology Physician
  • Valdosta, GA
  • NPI 1780681544
  Medicare reassignment NPD

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

{
    "created_epoch": "1172707200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1487782637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3024 N PATTERSON ST",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "316021711",
            "telephone_number": "229-247-4114",
            "fax_number": "229-245-9042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3024 N PATTERSON ST",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "316021711",
            "telephone_number": "229-247-4114",
            "fax_number": "229-245-9042"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYEASSOCIATES SURGERY CENTER, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-01",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SINCLAIR",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "229-247-4114",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "GA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Evolve Therapy Solutions LLC
• Ashley Exum, WHNP-BC
• Michael Shane Exum
• Eye Associates of Valdosta
• Eye Center Optical, LLC
• Family Home Medical Equipment & Supplies, LLC
• Family Insight, LLC
• Family Journeys, LLC
• Roohi Farooq
• Moriamo Adedoyin Fashugba, MD

• Ambulatory Surgical Clinic/Center in Valdosta, GA
• Providers in Valdosta, GA by specialty
• Ambulatory Surgical Clinic/Center in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.