Ellen Drury Fitzgerald, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPT002104 Issued in GA

Practice address

1329 Ocilla Rd
Douglas, GA 31533-2213

Phone

(912) 393-0005

Fax

(912) 393-0058

NPI assigned

Aug 10, 2006

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

Other identifiers 6

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

Other, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ellen.fitzgerald@ffeyecare.eyefinity-direct.com

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.

• Fitzgerald Family Eyecare, P.C.

  • Optometrist
  • Douglas, GA
  • NPI 1114938727
  Medicare reassignment NPD Authorized official
• Eye Care of Waycross PC

  • Exclusive Provider Organization
  • Waycross, GA
  • NPI 1851571384
  NPD (past)

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

{
    "created_epoch": "1155168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659052800000",
    "number": "1629089222",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1329 OCILLA RD",
            "city": "DOUGLAS",
            "state": "GA",
            "postal_code": "315332213",
            "telephone_number": "912-393-0005",
            "fax_number": "912-393-0058"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1329 OCILLA RD",
            "city": "DOUGLAS",
            "state": "GA",
            "postal_code": "315332213",
            "telephone_number": "912-393-0005",
            "fax_number": "912-393-0058"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FITZGERALD",
        "first_name": "ELLEN",
        "middle_name": "DRURY",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-10",
        "last_updated": "2022-07-29",
        "certification_date": "2022-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "GA",
            "license": "OPT002104",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "535526348B",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7298815",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AVESIS",
            "identifier": "VGA001714",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "52144366-003",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "101527",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "202177960",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kelsea Renea Fender, FNP
• Sarah Allyson Fender
• Shamika Lashonda Fernandez
• Joel W Ferree, MD
• Fitzgerald Family Eyecare, P.C.
• Michael S. Flory, APRN
• Tequoria Flowers
• Susan Ivey Fortner, M.ED., CF/SLP
• Syria Frost
• James Timothy Fussell, D.M.D

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2022; 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.