Ryan Kwan, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPT002966 Issued in GA

Practice address

4875 Altama Ave
Brunswick, GA 31520-2912

Phone

(912) 554-0010

Fax

(912) 554-0075

NPI assigned

Aug 10, 2016

Last updated

Jan 22, 2021By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• American Eyecare Center of Jesup Inc

  • Optometrist
  • Jesup, GA
  • NPI 1376610618
  Medicare reassignment NPD
• Myeyedr Optometry of Georgia, LLC

  dba MyEyeDr.

  • Optometrist
  • Rincon, GA
  • NPI 1437294592
  Medicare reassignment NPD
• Myeyedr Optometry of Georgia, LLC

  dba MyEyeDr.

  • Optometrist
  • Brunswick, GA
  • NPI 1043355605
  NPD
• Myeyedr Optometry of Georgia, LLC

  dba MyEyeDr.

  • Optometrist
  • Tyrone, GA
  • NPI 1275326571
  NPD

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

{
    "created_epoch": "1470787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611273600000",
    "number": "1871047613",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "198 SW BROAD ST",
            "city": "JESUP",
            "state": "GA",
            "postal_code": "315451101",
            "telephone_number": "912-530-6000",
            "fax_number": "912-530-6044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4875 ALTAMA AVE",
            "city": "BRUNSWICK",
            "state": "GA",
            "postal_code": "315202912",
            "telephone_number": "912-554-0010",
            "fax_number": "912-554-0075"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4875 Altama Ave",
            "address_purpose": "LOCATION",
            "city": "Brunswick",
            "state": "GA",
            "postal_code": "315202912",
            "country_code": "US",
            "telephone_number": "912-554-0010",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KWAN",
        "first_name": "RYAN",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-08-10",
        "last_updated": "2021-01-22",
        "certification_date": "2021-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "GA",
            "license": "OPT002966",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Iris Kufahl, RN
• Avesh Kumar, M.D
• Sanjay Kumar, M.D.
• Payal Kumari, M.D
• Chelsea Kurrasch
• Lutas Labarba, LAPC
• Laboratory Corporation of America Holdings
• Brian David Labudde
• Graham Alexander Laidler, PT
• Royce K Laidler, CCC/SLP

• Optometrist in Brunswick, GA
• Providers in Brunswick, GA by specialty
• Optometrist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2021; 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.