Individual provider Active NPI

John Robert Zechmann, O.D.

  • Optometrist
  • Brunswick, GA
National Provider Identifier
1528086147
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT000976 Issued in GA
Practice address
4875 Altama Ave
Brunswick, GA 31520-2912
Phone
(912) 554-0010
Fax
(912) 554-0075
NPI assigned
Jul 18, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPT000976 GA Primary

Addresses

Primary practice location

4875 Altama Ave
Brunswick, GA 31520-2912

Mailing address

1950 Old Gallows Rd Ste 520
Vienna, VA 22182-3970
Phone (703) 847-8899

Other practice location 1

2215 Memorial Dr Ste 25
Waycross, GA 31501-0987
Phone (912) 285-2021

Other practice location 2

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

Other identifiers 2

IdentifierTypeStateIssuer
5705800001OtherGACIGNA GOVERNMENT SERVICES
000348906AMedicaidGA

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20040323000907 GA Practitioner - Optometry 7810887080 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPT000976GAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Myeyedr Optometry of Georgia, LLC Optometrist CurrentSince Jul 13, 2015 Accepting new patients
Myeyedr Optometry of Georgia, LLC Optometrist Current Accepting new patients
Myeyedr Optometry of Georgia, LLC Optometrist CurrentSince Jul 13, 2015 Accepting new patients
Eye Care of Waycross PC PastSince May 19, 1990 Accepting new patients

Locations

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

2215 Memorial Dr
Ste 25
Waycross, GA 31501
Phone (912) 285-2021

8614 Westwood Center Dr
Fl 9
Vienna, VA 22182

1950 Old Gallows Rd
Ste 520
Vienna, VA 22182

Organizations & group practices 4

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

NPI Registry JSON

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

{
    "created_epoch": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1528086147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1950 OLD GALLOWS RD STE 520",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221823970",
            "telephone_number": "703-847-8899",
            "fax_number": "866-795-4020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4875 ALTAMA AVE",
            "city": "BRUNSWICK",
            "state": "GA",
            "postal_code": "315202912",
            "telephone_number": "912-554-0010",
            "fax_number": "912-554-0075"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2215 Memorial Dr Ste 25",
            "address_purpose": "LOCATION",
            "city": "Waycross",
            "state": "GA",
            "postal_code": "315010987",
            "country_code": "US",
            "telephone_number": "912-285-2021",
            "fax_number": "912-285-5558",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4875 Altama Ave",
            "address_purpose": "LOCATION",
            "city": "Brunswick",
            "state": "GA",
            "postal_code": "315202912",
            "country_code": "US",
            "telephone_number": "912-554-0010",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ZECHMANN",
        "first_name": "JOHN",
        "middle_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-18",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "GA",
            "license": "OPT000976",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA GOVERNMENT SERVICES",
            "identifier": "5705800001",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000348906A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brunswick, GA

Sources for this page

Verify at the official NPI Registry.