NPIMap

Organization Active NPI

Eye Care of Waycross PC

  • Exclusive Provider Organization
  • Waycross, GA
National Provider Identifier
1851571384
Registry record updated Aug 22, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Exclusive Provider OrganizationTaxonomy code 302F00000X
License
0976T Issued in GA
Legal business name
EYE CARE OF WAYCROSS PC
Practice address
2215 Memorial Dr
Suite 25
Waycross, GA 31501-0983
Phone
(912) 285-2021
Fax
(912) 285-2558
NPI assigned
Nov 13, 2007
Last updated
Aug 22, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2011

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

Authorized official

Name
Dr. John Robert Zechmann, ODNPI 1528086147
Title
Optometrist
Phone
(912) 285-2021

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
Exclusive Provider Organization 302F00000X 0976T GA Primary

Addresses

Primary practice location

2215 Memorial Dr
Suite 25
Waycross, GA 31501-0983

Mailing address

2215 Memorial Dr
Suite 25
Waycross, GA 31501-0983
Phone (912) 285-2021

Other identifiers 1

IdentifierTypeStateIssuer
000348906AMedicaidGA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 5

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": "1194912000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1313971200000",
    "number": "1851571384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2215 MEMORIAL DR",
            "address_2": "SUITE 25",
            "city": "WAYCROSS",
            "state": "GA",
            "postal_code": "315010983",
            "telephone_number": "912-285-2021",
            "fax_number": "912-285-2558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2215 MEMORIAL DR",
            "address_2": "SUITE 25",
            "city": "WAYCROSS",
            "state": "GA",
            "postal_code": "315010983",
            "telephone_number": "912-285-2021",
            "fax_number": "912-285-2558"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYE CARE OF WAYCROSS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-13",
        "last_updated": "2011-08-22",
        "status": "A",
        "authorized_official_last_name": "ZECHMANN",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "ROBERT",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "912-285-2021",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "302F00000X",
            "taxonomy_group": "",
            "desc": "Exclusive Provider Organization",
            "state": "GA",
            "license": "0976T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000348906A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Waycross, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.