Northeast Georgia Ophthalmology, LLC

Primary specialty

Ophthalmologic Surgery Clinic/CenterTaxonomy code 261QS0132X

Legal business name

NORTHEAST GEORGIA OPHTHALMOLOGY, LLC

Practice address

1498 Jesse Jewell Pkwy SE Ste B
Gainesville, GA 30501-3874

Phone

(770) 596-8605

Fax

(713) 903-7907

NPI assigned

Jun 8, 2020

Organization subpart

No

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

Authorized official

Name

Vandana C. Reddy, MDNPI 1740444322

Title

Owner/Physician

Phone

(770) 767-3937

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Vandana C Reddy, MD

  • Ophthalmology Physician
  • Gainesville, GA
  • NPI 1740444322
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1591574400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1592956800000",
    "number": "1689298457",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "195 14TH ST NE UNIT 805",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303092673",
            "telephone_number": "770-596-8605",
            "fax_number": "713-903-7907"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1498 JESSE JEWELL PKWY SE STE B",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305013874",
            "telephone_number": "770-596-8605",
            "fax_number": "713-903-7907"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHEAST GEORGIA OPHTHALMOLOGY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-06-08",
        "last_updated": "2020-06-24",
        "certification_date": "2020-06-24",
        "status": "A",
        "authorized_official_last_name": "REDDY",
        "authorized_official_first_name": "VANDANA",
        "authorized_official_middle_name": "C.",
        "authorized_official_title_or_position": "OWNER/PHYSICIAN",
        "authorized_official_telephone_number": "770-767-3937",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QS0132X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ophthalmologic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Northeast Georgia Medical Center, Inc.
• Northeast Georgia Medical Center, Inc.
• Northeast Georgia Medical Center, Inc.
• Northeast Georgia Medical Center, Inc.
• Northeast Georgia Medical Center., Inc.
• Northeast Georgia Orthopaedics & Sports Medicine, LLC
• Northeast Georgia Otolaryngology
• Northeast Georgia Physicians Group
• Northeast Georgia Physicians Group Inc
• Northeast Georgia Physicians Group Urgent Care LLC

• Ophthalmologic Surgery Clinic/Center in Gainesville, GA
• Providers in Gainesville, GA by specialty
• Ophthalmologic Surgery Clinic/Center in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.