Active NPI
Diana Maurer, O.D.
- Optometrist
- Waycross, GA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- OPT001210
- Practice address
- 2209 Memorial Dr
Waycross, GA 31501-0902 - Phone
- (912) 285-2021
- Fax
- (912) 285-2558
- NPI assigned
- Jan 24, 2007
- Last updated
- Nov 17, 2023
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | OPT001210 | GA | Primary |
Addresses
Primary practice location
2209 Memorial Dr
Waycross, GA 31501-0902
Mailing address
8614 Westwood Center Dr FL 9
Vienna, VA 22182-2442
Phone (703) 847-8899
Other practice location 1
15328 US Highway 19 S
Thomasville, GA 31757-4824
Phone (229) 227-1940
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000872781A | Medicaid | GA | |
| 101698 | Other | GA | AVESIS RUN GA MEDICAID |
| 08529 | Other | SPECTERA INS ID |
Medicare participation
Medicare enrollment files- 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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Optometry
- Education
- University Alabama Birmingham - School of Optometry, 1989
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
2209 Memorial Dr
Waycross, GA 31501-0902
Phone (912) 285-2021
4875 Altama Ave
Brunswick, GA 31520-2912
Phone (912) 554-0010
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 001210 | GA | MD | Social Worker |
| OPT001210 | GA | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Myeyedr Optometry of Georgia, LLC | Optometrist | Current | Accepting new patients |
| Myeyedr Optometry of Georgia, LLC | Optometrist | Current | Accepting new patients |
| Myeyedr Optometry of Georgia, LLC | Optometrist | Current | Accepting new patients |
| Myeyedr Optometry of Georgia, LLC | Optometrist | Past | Accepting new patients |
Locations
4875 Altama Ave
Brunswick, GA 31520
Phone (912) 554-0010
2003 Commerce Dr
Ste 40
Kingsland, GA 31548
15196 US Highway 19 S
Thomasville, GA 31757
Phone (229) 228-4770
2209 Memorial Dr
Waycross, GA 31501
Phone (912) 285-2021
8614 Westwood Center Dr
Fl 9
Vienna, VA 22182
Organizations & group practices 4
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169596800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1700179200000",
"number": "1891840617",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8614 WESTWOOD CENTER DR FL 9",
"city": "VIENNA",
"state": "VA",
"postal_code": "221822442",
"telephone_number": "703-847-8899",
"fax_number": "571-223-6780"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2209 MEMORIAL DR",
"city": "WAYCROSS",
"state": "GA",
"postal_code": "315010902",
"telephone_number": "912-285-2021",
"fax_number": "912-285-2558"
}
],
"practiceLocations": [
{
"address_1": "15328 US Highway 19 S",
"address_purpose": "LOCATION",
"city": "Thomasville",
"state": "GA",
"postal_code": "317574824",
"country_code": "US",
"telephone_number": "229-227-1940",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MAURER",
"first_name": "DIANA",
"credential": "O.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-01-24",
"last_updated": "2023-11-17",
"certification_date": "2023-11-17",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "GA",
"license": "OPT001210",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "000872781A",
"state": "GA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AVESIS RUN GA MEDICAID",
"identifier": "101698",
"state": "GA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SPECTERA INS ID",
"identifier": "08529",
"state": null
}
],
"endpoints": [],
"other_names": []
}
Other providers in Waycross, GA
- Kristen Brooke Martin, APRN, FNP-C
- Virginia Martin, O.D.
- Ellisa A Mathis, FNP'C
- Kalie Deann Mathis, NP-C
- Scott Mathis, APRN,BC
- Mayo Clinic Health System in Waycross
- Mayo Clinic Health System in Waycross, Inc
- Mayo Clinic Health System in Waycross, Inc. (Satilla Care Center)
- Mayo Clinic Health System in Waycross, Inc.
- Mayo Clinic Health System in Waycross, Inc.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2023; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.