Individual provider Active NPI

Virginia Martin, O.D.

  • Optometrist
  • Waycross, GA
National Provider Identifier
1497101125
Registry record updated Aug 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT003002 Issued in GA
Practice address
2209 Memorial Dr
Waycross, GA 31501-0902
Phone
(912) 285-2021
Fax
(912) 285-2558
NPI assigned
May 12, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2897 OK
Optometrist 152W00000X OPT003002 GA Primary

Addresses

Primary practice location

2209 Memorial Dr
Waycross, GA 31501-0902

Mailing address

8614 Westwood Center Dr FL 9
Vienna, VA 22182-2442
Phone (703) 847-8899

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, MA, VA3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20170719003973 GA Practitioner - Optometry 9537439872 Reassigns benefits to 1 organization
I20250502001574 MA Practitioner - Optometry 9537439872 Reassigns benefits to 1 organization
I20260604000785 VA Practitioner - Optometry 9537439872 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University Alabama Birmingham - School of Optometry, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Myeyedr Optometry of Georgia, LLCGroup PAC ID 8224261201, 100 clinicians
Myeyedr Optometry of Massachusetts P CGroup PAC ID 1951661297, 57 clinicians

Practice addresses (Care Compare)

15196 US Hwy 19 S
Thomasville, GA 31757-4820
Phone (229) 228-4770

198 S Houston Lake Rd
Suite B
Warner Robins, GA 31088-6475
Phone (478) 971-1500

198 S Houston Lake Rd B
Warner Robins, GA 31088-6475
Phone (478) 971-1500

22 University Dr
Amherst, MA 01002-2243
Phone (413) 549-9400

2610 Dawson Rd
Albany, GA 31707-1682
Phone (229) 439-4687

426 N Main St
East Longmeadow, MA 01028-1850
Phone (413) 525-4888

4875 Altama Ave
Brunswick, GA 31520-2912
Phone (912) 554-0010

489 Bernardston Rd
Greenfield, MA 01301-1238
Phone (413) 772-2571

Merit-based Incentive Payment System (MIPS)

Final score
50 of 100Reported as group
Quality
0
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2897OKMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Myeyedr Optometry of Georgia, LLC Optometrist Current Accepting new patients
Myeyedr Optometry of Georgia, LLC Optometrist CurrentSince Aug 28, 2024 Accepting new patients
Myeyedr Optometry of Massachusetts P C Optometrist CurrentSince Apr 16, 2025 Accepting new patients
Myeyedr Optometry of Massachusetts P C Optometrist CurrentSince Apr 16, 2025 Accepting new patients

Locations

4875 Altama Ave
Brunswick, GA 31520
Phone (912) 554-0010

911 N 3rd Ave
Chatsworth, GA 30705
Phone (706) 695-4676

1601 Macon Rd
Perry, GA 31069
Phone (478) 218-0404

22 University Dr
Amherst, MA 01002
Phone (413) 549-9400

426 N Main St
East Longmeadow, MA 01028
Phone (413) 525-3010

489 Bernardston Rd
Greenfield, MA 01301
Phone (413) 772-2571

8614 Westwood Center Dr
Fl 9
Vienna, VA 22182

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1463011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723593600000",
    "number": "1497101125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8614 WESTWOOD CENTER DR FL 9",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221822442",
            "telephone_number": "703-847-8899",
            "fax_number": "571-223-6780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2209 MEMORIAL DR",
            "city": "WAYCROSS",
            "state": "GA",
            "postal_code": "315010902",
            "telephone_number": "912-285-2021",
            "fax_number": "912-285-2558"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "VIRGINIA",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-12",
        "last_updated": "2024-08-14",
        "certification_date": "2024-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OK",
            "license": "2897",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "GA",
            "license": "OPT003002",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waycross, GA

Sources for this page

Verify at the official NPI Registry.