NPIMap

Organization Active NPI

Kenneth C. Fries, O.D., P.C.

  • Optometrist
  • Pooler, GA
National Provider Identifier
1851675441
Registry record updated Oct 1, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
GAOPT001492 Issued in GA
Legal business name
KENNETH C. FRIES, O.D., P.C.
Practice address
412 US Highway 80 SW
Pooler, GA 31322-2541
Phone
(912) 748-3937
Fax
(912) 748-6758
NPI assigned
Oct 1, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2011

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

Authorized official

Name
Dr. Kenneth C Fries, O.D.NPI 1629157045
Title
Owner
Phone
(912) 272-6121

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 GAOPT001492 GA Primary

Addresses

Primary practice location

412 US Highway 80 SW
Pooler, GA 31322-2541

Mailing address

PO Box 14116
Savannah, GA 31416-1116
Phone (912) 272-6121

National Provider Directory

National Provider Directory

Locations

412 US Highway 80 SW
Pooler, GA 31322
Phone (912) 348-2302

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1317427200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1317427200000",
    "number": "1851675441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 14116",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314161116",
            "telephone_number": "912-272-6121",
            "fax_number": "912-691-1277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "412 US HIGHWAY 80 SW",
            "city": "POOLER",
            "state": "GA",
            "postal_code": "313222541",
            "telephone_number": "912-748-3937",
            "fax_number": "912-748-6758"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENNETH C. FRIES, O.D., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-10-01",
        "last_updated": "2011-10-01",
        "status": "A",
        "authorized_official_last_name": "FRIES",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "912-272-6121",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "GA",
            "license": "GAOPT001492",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pooler, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 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.