Emily Champion, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPT003157 Issued in GA

Practice address

147 Northside Dr E
Statesboro, GA 30458-4760

Phone

(912) 764-7914

NPI assigned

Jun 22, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Optometry

Education

Illinois College of Optometry at Chicago, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Low Country Eye Associates, PCGroup PAC ID 8729984786, 8 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Low Country Eye Associates, PC

  • Optometrist
  • Pooler, GA
  • NPI 1225173578
  Medicare reassignment Care Compare group NPD
• Southcoast Medical Group, LLC

  • Family Medicine Physician
  • Savannah, GA
  • NPI 1467451922
  NPD (past)

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

{
    "created_epoch": "1561161600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561161600000",
    "number": "1538720438",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1881 SS RAILROAD BED RD APT 203",
            "city": "STATESBORO",
            "state": "GA",
            "postal_code": "304618612",
            "telephone_number": "423-432-5304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "147 NORTHSIDE DR E",
            "city": "STATESBORO",
            "state": "GA",
            "postal_code": "304584760",
            "telephone_number": "912-764-7914"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAMPION",
        "first_name": "EMILY",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-22",
        "last_updated": "2019-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "GA",
            "license": "OPT003157",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Breanna Morris Carter, M.ED. LPC NCC
• Elyse Bridget Casher, MSW, LCSW
• Stephen Cauley, O.D.
• Cedar Surgical Associates, PC
• Cesar Clinic, LLC
• Cullen Brooke Chance, SLP
• Evan L Chance, SERVICE COORDINATOR
• Kendra Ashley Chandler
• Maryn Clements Chandler, PA-C
• Athena Paraskevi Chapel, D.M.D.

• Optometrist in Statesboro, GA
• Providers in Statesboro, GA by specialty
• Optometrist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.