Organization Active NPI

Joseph Pittman OD PC

  • Optometrist
  • Hinesville, GA
National Provider Identifier
1750564738
Registry record updated May 12, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
JOSEPH PITTMAN OD PC
Practice address
556 W Oglethorpe Hwy
Hinesville, GA 31313-4489
Phone
(912) 368-2020
Fax
(912) 368-2049
NPI assigned
Dec 12, 2007
Last updated
May 12, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 12, 2010

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

Authorized official

Name
Joseph Edward Pittman, ODNPI 1386742773
Title
Owner
Phone
(912) 368-2020

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X Primary

Addresses

Primary practice location

556 W Oglethorpe Hwy
Hinesville, GA 31313-4489

Mailing address

556 W Oglethorpe Hwy
Hinesville, GA 31313-4489
Phone (912) 368-2020

Other identifiers 3

IdentifierTypeStateIssuer
OPT002043OtherGATRICARE SOUTH
513045421AMedicaidGA
892142OtherGABCBSGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040622001068 GA Part B Supplier - Clinic/Group Practice 9234114364 Receives reassigned benefits from 2 practitioners
Practice locations: Hinesville, GA

National Provider Directory

National Provider Directory

Locations

25 County Shop Rd SE
Ludowici, GA 31316
Phone (912) 368-2020

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1197417600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1273622400000",
    "number": "1750564738",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "556 W OGLETHORPE HWY",
            "city": "HINESVILLE",
            "state": "GA",
            "postal_code": "313134489",
            "telephone_number": "912-368-2020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "556 W OGLETHORPE HWY",
            "city": "HINESVILLE",
            "state": "GA",
            "postal_code": "313134489",
            "telephone_number": "912-368-2020",
            "fax_number": "912-368-2049"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOSEPH PITTMAN OD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-12",
        "last_updated": "2010-05-12",
        "status": "A",
        "authorized_official_last_name": "PITTMAN",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "EDWARD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "912-368-2020",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE SOUTH",
            "identifier": "OPT002043",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "513045421A",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSGA",
            "identifier": "892142",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hinesville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2010; 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.