Angela Beth Ellerman, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

2022 Issued in GA

Practice address

55 Carlton St
Athens, GA 30602-1503

Phone

(706) 542-5617

Fax

(706) 227-4763

NPI assigned

Jan 11, 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 1

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Board of Regents of the University System of Georgia

  • Audiologist
  • Athens, GA
  • NPI 1376640557
  Medicare reassignment NPD
• Lee, Ellerman, and Associates, OD, PC

  • Optometrist
  • Madison, GA
  • NPI 1730385329
  NPD (past) Authorized official
• Advanced Family Eyecare of Madison, PC

  • Optometrist
  • Madison, GA
  • NPI 1942323126
  NPD
• Board of Regents of the University System of Georgia

  • Point of Service
  • Athens, GA
  • NPI 1538311006
  NPD
• Board of Regents of the University System of Georgia

  • Pharmacy
  • Athens, GA
  • NPI 1629394820
  NPD
• University Health Center, University of Ga Health Center Pharmacy

  • Pharmacist
  • Athens, GA
  • NPI 1558435784
  NPD (past)

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

{
    "created_epoch": "1136937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660176000000",
    "number": "1730168485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 CARLTON ST",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "306021503",
            "telephone_number": "706-542-5617",
            "fax_number": "706-227-4763"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 CARLTON ST",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "306021503",
            "telephone_number": "706-542-5617",
            "fax_number": "706-227-4763"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLERMAN",
        "first_name": "ANGELA",
        "middle_name": "BETH",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-11",
        "last_updated": "2022-08-11",
        "certification_date": "2022-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "GA",
            "license": "2022",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "465525028C",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Eli Solomon, Psy.D., P.C.
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• Sharif Fiesal Elkabbani, MD
• Ellen Bargeron Therapy, LLC
• Ellen P. Klein, MSW, PC
• Ron Elliott, MD
• Tyler-Curtis Cory Elliott, MED, BCBA
• Catherine Paige Ellis, LMSW
• Mark A Ellis, MD
• April Lynne Ellison, RN

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.