Organization Active NPI

Georgia Eye Institute of the Southeast, LLC

  • Ophthalmology Physician
  • Pooler, GA
National Provider Identifier
1508119207
Registry record updated Jul 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
GEORGIA EYE INSTITUTE OF THE SOUTHEAST, LLC
Practice address
1000 Towne Center Blvd
Pooler, GA 31322-4052
Phone
(912) 354-4800
Fax
(912) 629-5821
NPI assigned
Oct 18, 2012
Last updated
Jul 16, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
GEORGIA EYE INSTITUTE OF THE SOUTHEAST, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 16, 2025

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

Authorized official

Name
Erica Leigh Moreland
Title
Director, Revenue Cycle
Phone
(912) 354-4800

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X
Ophthalmology Physician 207W00000X Primary

Addresses

Primary practice location

1000 Towne Center Blvd
Pooler, GA 31322-4052

Mailing address

4720 Waters Ave
Savannah, GA 31404-6292
Phone (912) 354-4800

National Provider Directory

National Provider Directory
Tax ID family
Georgia Eye Institute of the Southeast LLC9 organizations share this tax ID, including this one
Part of
Georgia Eye Institute of the Southeast LLC

Other organizations with this tax ID 8

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1350518400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1752624000000",
    "number": "1508119207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4720 WATERS AVE",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314046292",
            "telephone_number": "912-354-4800",
            "fax_number": "912-629-5821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 TOWNE CENTER BLVD",
            "city": "POOLER",
            "state": "GA",
            "postal_code": "313224052",
            "telephone_number": "912-354-4800",
            "fax_number": "912-629-5821"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GEORGIA EYE INSTITUTE OF THE SOUTHEAST, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GEORGIA EYE INSTITUTE OF THE SOUTHEAST, LLC",
        "enumeration_date": "2012-10-18",
        "last_updated": "2025-07-16",
        "certification_date": "2025-07-16",
        "status": "A",
        "authorized_official_last_name": "MORELAND",
        "authorized_official_first_name": "ERICA",
        "authorized_official_middle_name": "LEIGH",
        "authorized_official_title_or_position": "DIRECTOR, REVENUE CYCLE",
        "authorized_official_telephone_number": "912-354-4800"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pooler, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2025; 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.