Individual provider Active NPI

Christine Anderson Kreide, OD

  • Optometrist
  • Pooler, GA
National Provider Identifier
1598709537
Registry record updated Jul 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT1194 Issued in GA
Practice address
1370 US Highway 80 E
Ste E
Pooler, GA 31322-8902
Phone
(912) 965-9605
Fax
(912) 965-9604
NPI assigned
Jun 16, 2006
Last updated
Jul 1, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPT1194 GA Primary

Addresses

Primary practice location

1370 US Highway 80 E
Ste E
Pooler, GA 31322-8902

Mailing address

125 Grand View Dr
Pooler, GA 31322-4043
Phone (912) 655-2120

Other names 1

  • Christine Anderson Kreide Former name

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
I20041213000757 GA Practitioner - Optometry 8921065863 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPT1194GAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Myeyedr Optometry of Georgia, LLC Optometrist CurrentSince Aug 8, 2022 Accepting new patients
Myeyedr Optometry of Georgia, LLC Optometrist CurrentSince Aug 8, 2022 Accepting new patients
Myeyedr Optometry of Georgia, LLC Optometrist Past Accepting new patients
Eye Pros PastSince Apr 1, 2006 Accepting new patients

Locations

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

105 Grand Central Blvd
Ste 110
Pooler, GA 31322
Phone (912) 450-9200

594 S Columbia Ave
Ste 200
Rincon, GA 31326
Phone (912) 826-0935

8614 Westwood Center Dr
Fl 9
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": "1150416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656633600000",
    "number": "1598709537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 GRAND VIEW DR",
            "city": "POOLER",
            "state": "GA",
            "postal_code": "313224043",
            "telephone_number": "912-655-2120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1370 US HIGHWAY 80 E",
            "address_2": "STE E",
            "city": "POOLER",
            "state": "GA",
            "postal_code": "313228902",
            "telephone_number": "912-965-9605",
            "fax_number": "912-965-9604"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KREIDE",
        "first_name": "CHRISTINE",
        "middle_name": "ANDERSON",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-16",
        "last_updated": "2022-07-01",
        "certification_date": "2022-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "GA",
            "license": "OPT1194",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHRISTINE",
            "last_name": "KREIDE",
            "middle_name": "ANDERSON",
            "credential": "OD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Pooler, GA

Sources for this page

Verify at the official NPI Registry.