Organization Active NPI

Ronald B. Yancey, P.C.

Doing business as Yancey Eye Center

  • Optometrist
  • Vidalia, GA
National Provider Identifier
1841317336
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1357T Issued in GA
Legal business name
RONALD B. YANCEY, P.C.
Doing business as
Yancey Eye Center
Practice address
303 Harris Industrial Blvd.
Suite 7
Vidalia, GA 30474-4752
Phone
(912) 537-4400
Fax
(912) 537-4233
NPI assigned
Mar 22, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mrs. Trisha Sharpe
Title
Business Manager
Phone
(912) 537-4400

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 1357T GA Primary

Addresses

Primary practice location

303 Harris Industrial Blvd.
Suite 7
Vidalia, GA 30474-4752

Mailing address

303 Harris Industrial Blvd.
Suite 7
Vidalia, GA 30474-4752
Phone (912) 537-4400

Other identifiers 1

IdentifierTypeStateIssuer
00514621DMedicaidGA

Other names 1

  • Yancey Eye Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070328000283 GA Part B Supplier - Clinic/Group Practice 1557465762 Receives reassigned benefits from 1 practitioner
Practice locations: Vidalia, GA

National Provider Directory

National Provider Directory

Locations

247 W Main St
Swainsboro, GA 30401
Phone (478) 237-7203

117 Church St
Vidalia, GA 30474
Phone (912) 537-4400

303 Harris Industrial Blvd
Ste 7
Vidalia, GA 30474
Phone (912) 537-4400

Practitioners & affiliated clinicians

Practitioners 1

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": "1174521600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1841317336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "303 HARRIS INDUSTRIAL BLVD.",
            "address_2": "SUITE 7",
            "city": "VIDALIA",
            "state": "GA",
            "postal_code": "304744752",
            "telephone_number": "912-537-4400",
            "fax_number": "912-537-4233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "303 HARRIS INDUSTRIAL BLVD.",
            "address_2": "SUITE 7",
            "city": "VIDALIA",
            "state": "GA",
            "postal_code": "304744752",
            "telephone_number": "912-537-4400",
            "fax_number": "912-537-4233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RONALD B. YANCEY, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-22",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SHARPE",
        "authorized_official_first_name": "TRISHA",
        "authorized_official_title_or_position": "BUSINESS MANAGER",
        "authorized_official_telephone_number": "912-537-4400",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "GA",
            "license": "1357T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00514621D",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Yancey Eye Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Vidalia, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.