Individual provider Active NPI

Sarah Brodhead Freeman, O.D.

  • Optometrist
  • Rincon, GA
National Provider Identifier
1841309895
Registry record updated Jan 16, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1491 Issued in GA
Practice address
6162 Ga Highway 21 S
Rincon, GA 31326-5507
Phone
(912) 826-3949
Fax
(888) 810-2083
NPI assigned
Aug 30, 2006
Last updated
Jan 16, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1491 GA Primary

Addresses

Primary practice location

6162 Ga Highway 21 S
Rincon, GA 31326-5507

Mailing address

6162 Ga Highway 21 S
Rincon, GA 31326-5507
Phone (912) 826-3949

Other identifiers 1

IdentifierTypeStateIssuer
000687805EMedicaidGA

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
I20100618000369 GA Practitioner - Optometry 2163521311 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
001491GAMDProfessional Counselor
1491GAMDClinical Neuropsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Effingham Eye Care Optometrist CurrentSince Jul 1, 2003 Accepting new patients

Locations

6162 Highway 21 S
Rincon, GA 31326
Phone (912) 826-3949

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1326672000000",
    "number": "1841309895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6162 GA HIGHWAY 21 S",
            "city": "RINCON",
            "state": "GA",
            "postal_code": "313265507",
            "telephone_number": "912-826-3949",
            "fax_number": "888-810-2083"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6162 GA HIGHWAY 21 S",
            "city": "RINCON",
            "state": "GA",
            "postal_code": "313265507",
            "telephone_number": "912-826-3949",
            "fax_number": "888-810-2083"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREEMAN",
        "first_name": "SARAH",
        "middle_name": "BRODHEAD",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-30",
        "last_updated": "2012-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "GA",
            "license": "1491",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000687805E",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rincon, GA

Sources for this page

Verify at the official NPI Registry.