Amy M. Stephens, O.D., P.a.

Key facts

NPI

1891817573

Entity type

Organization (NPI type 2)

Primary specialty

Optometrist 152W00000X

License

001621 (GA)

Legal business name

AMY M. STEPHENS, O.D., P.A.

Practice address

15196 US Highway 19 S
Thomasville, GA 31757-4820

Phone

(229) 228-4770

Fax

(229) 225-9060

NPI assigned

Apr 4, 2007

Organization subpart

No

Authorized official

Name

Dr. Amy M. Stephens, O.D. NPI 1598825184

Title

Doctor, Owner

Phone

(229) 228-4770

Authorized official NPPES reports the authorized official by name only; the link goes to the one practitioner connected to this organization with that name.

Practitioners 1

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

• Amy M Stephens, O.D. Optometrist · Thomasville, GA · NPI 1598825184
  NPD Authorized official OPTOMETRIST

National Provider Directory

Locations

Specialties & licenses

Addresses

Other identifiers

Other names

• Eye Savers Doing business as

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Aug 12, 2008.

{
    "created_epoch": "1175644800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1218499200000",
    "number": "1891817573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1480 TIMBERLANE RD",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323121713",
            "telephone_number": "850-894-2332",
            "fax_number": "850-668-8625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15196 US HIGHWAY 19 S",
            "city": "THOMASVILLE",
            "state": "GA",
            "postal_code": "317574820",
            "telephone_number": "229-228-4770",
            "fax_number": "229-225-9060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMY M. STEPHENS, O.D., P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-04",
        "last_updated": "2008-08-12",
        "status": "A",
        "authorized_official_last_name": "STEPHENS",
        "authorized_official_first_name": "AMY",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "DOCTOR, OWNER",
        "authorized_official_telephone_number": "229-228-4770",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "GA",
            "license": "001621",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00825833A",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SPECTERA",
            "identifier": "07566",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AVESIS-GROUP",
            "identifier": "44253",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AVESIS MEDICAID",
            "identifier": "92033",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Eye Savers",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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