Active NPI
Fernanda R Pereira, OD
- Optometrist
- Fort Eisenhower, GA
National Provider Identifier
1699547679
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 6370
- Practice address
- 300 E Hospital Rd
Fort Eisenhower, GA 30905 - Phone
- (706) 787-7155
- NPI assigned
- Oct 24, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 6370 | FL | Primary |
Addresses
Primary practice location
300 E Hospital Rd
Fort Eisenhower, GA 30905
Mailing address
12712 Aquamarine Ave
Bradenton, FL 34211-1200
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6370 | FL | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1698105600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1712102400000",
"number": "1699547679",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12712 AQUAMARINE AVE",
"city": "BRADENTON",
"state": "FL",
"postal_code": "342111200"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "300 E HOSPITAL RD",
"city": "FORT EISENHOWER",
"state": "GA",
"postal_code": "30905",
"telephone_number": "706-787-7155"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PEREIRA",
"first_name": "FERNANDA",
"middle_name": "R",
"credential": "OD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-10-24",
"last_updated": "2024-04-03",
"certification_date": "2024-04-03",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "FL",
"license": "6370",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Eisenhower, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.