Individual provider Active NPI

Darrell Allen Sorah Jr., OD

  • Optometrist
  • Winder, GA
National Provider Identifier
1679577258
Registry record updated Mar 19, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1513 Issued in GA
Practice address
90 Church St
Winder, GA 30680-1714
Phone
(770) 867-2505
Fax
(770) 867-8668
NPI assigned
Jun 10, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1513 GA Primary

Addresses

Primary practice location

90 Church St
Winder, GA 30680-1714

Mailing address

P O Box 608
Winder, GA 30680-0608
Phone (770) 867-2505

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
I20111107000583 GA Practitioner - Optometry 6608879580 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Winder Eye Care CenterGroup PAC ID 1153312871, 4 clinicians

Practice addresses (Care Compare)

279 N Broad St
Suite C
Winder, GA 30680-2589
Phone (770) 867-2505

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
1513GAMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Winder Eye Care Center Optometrist CurrentSince Sep 26, 1995 Accepting new patients
Premier Vision Partners Optometrist CurrentSince Sep 1, 2021 Accepting new patients
Eye Institute of North Georgia, PC Past Accepting new patients
Georgia Eye LLC Optometrist PastSince Sep 1, 2021 Accepting new patients

Locations

5391 Highway 53
Ste 102
Braselton, GA 30517
Phone (706) 546-0170

279 N Broad St
Ste C
Winder, GA 30680
Phone (404) 867-2505

90 Church St
Winder, GA 30680
Phone (770) 867-2505

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1118361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1268956800000",
    "number": "1679577258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P O BOX 608",
            "city": "WINDER",
            "state": "GA",
            "postal_code": "306800608",
            "telephone_number": "770-867-2505",
            "fax_number": "770-867-8668"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "90 CHURCH ST",
            "city": "WINDER",
            "state": "GA",
            "postal_code": "306801714",
            "telephone_number": "770-867-2505",
            "fax_number": "770-867-8668"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SORAH",
        "first_name": "DARRELL",
        "middle_name": "ALLEN",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-10",
        "last_updated": "2010-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "GA",
            "license": "1513",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winder, GA

Sources for this page

Verify at the official NPI Registry.