Individual provider Active NPI

Casey N Roland, O.D.

  • Optometrist
  • Evans, GA
National Provider Identifier
1912105370
Registry record updated Mar 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT002397 Issued in GA
Practice address
4409 Evans to Locks Rd
Evans, GA 30809-3603
Phone
(706) 396-7671
Fax
(706) 228-4692
NPI assigned
Jul 6, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 26, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPT002397 GA Primary

Addresses

Primary practice location

4409 Evans to Locks Rd
Evans, GA 30809-3603

Mailing address

4409 Evans to Locks Rd
Evans, GA 30809-3603
Phone (706) 396-7671

Other identifiers 1

IdentifierTypeStateIssuer
286172120AMedicaidGA

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080414000624 GA Practitioner - Optometry 7911084082 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University Alabama Birmingham - School of Optometry, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Casey N Roland, OD, PCGroup PAC ID 8325268337, 2 clinicians

Practice addresses (Care Compare)

4409 Evans to Locks Rd
Evans, GA 30809-3603
Phone (706) 396-7671

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Casey N Roland, OD, PC Optometrist CurrentSince Aug 1, 2014 Accepting new patients

Locations

4409 Evans To Locks Rd
Evans, GA 30809
Phone (706) 396-7671

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1183680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711411200000",
    "number": "1912105370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4409 EVANS TO LOCKS RD",
            "city": "EVANS",
            "state": "GA",
            "postal_code": "308093603",
            "telephone_number": "706-396-7671",
            "fax_number": "706-228-4692"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4409 EVANS TO LOCKS RD",
            "city": "EVANS",
            "state": "GA",
            "postal_code": "308093603",
            "telephone_number": "706-396-7671",
            "fax_number": "706-228-4692"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROLAND",
        "first_name": "CASEY",
        "middle_name": "N",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-07-06",
        "last_updated": "2024-03-26",
        "certification_date": "2024-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "GA",
            "license": "OPT002397",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "286172120A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Evans, GA

Sources for this page

Verify at the official NPI Registry.