Tracie L Sponseller, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPT002160 Issued in GA

Practice address

3152 Washington Rd
Augusta, GA 30907-3891

Phone

(706) 651-1291

Fax

(706) 210-8090

NPI assigned

Aug 4, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in GA, SC2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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

• S & H Eye Care, LLC

  • Optometrist
  • Augusta, GA
  • NPI 1447537519

  GA, Optometrist

  Medicare reassignment NPD Authorized official
• S & H Eye Care, LLC

  • Optometrist
  • Aiken, SC
  • NPI 1528345691
  Medicare reassignment NPD Authorized official
• Au Medical Associates Inc

  • Multi-Specialty Clinic/Center
  • Augusta, GA
  • NPI 1841230620

  GA

  Medicare reassignment NPD
• Au Medical Center, Inc

  • General Acute Care Hospital
  • Augusta, GA
  • NPI 1437135902

  GA

  Medicare reassignment NPD
• S & H Eye Care, LLC

  • Optometrist
  • Aiken, SC
  • NPI 1427333509
  NPD Authorized official
• Au Medical Associates Inc

  • Durable Medical Equipment & Medical Supplies
  • Augusta, GA
  • NPI 1114574126
  NPD
• Au Medical Center, Inc.

  • Community/Retail Pharmacy
  • Augusta, GA
  • NPI 1487901476
  NPD
• S & H Eye Care, LLC

  • Optometrist
  • Beaufort, SC
  • NPI 1043574536
  NPD
• LTC Eyecare Inc

  • Optometrist
  • Georgetown, SC
  • NPI 1225084676
  NPD (past)

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

{
    "created_epoch": "1154649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1394409600000",
    "number": "1861400517",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3152 WASHINGTON RD",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309073891",
            "telephone_number": "706-651-1291",
            "fax_number": "706-210-8090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3152 WASHINGTON RD",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309073891",
            "telephone_number": "706-651-1291",
            "fax_number": "706-210-8090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPONSELLER",
        "first_name": "TRACIE",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-04",
        "last_updated": "2014-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "GA",
            "license": "OPT002160",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "329735702C",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "329735702A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Spine Center Augusta, LLC
• Bobby Jack Spivey III, MD
• Sponseller Eye Care One
• Sponseller Eye Care One PC
• Jeffery L Sponseller, OD
• Sport & Injury Bodyworks
• Claude Sportes, M.D.
• Sports Medicine Associates of Augusta, LLC
• Sports Medicine Associates of Augusta, LLC
• Rebecca D Spott, PA

• All providers in Augusta, GA
• Optometrist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.