Active NPI
Amedco Georgia LLC
Doing business as Tifton Ophthalmology
- Ophthalmology Physician
- Tifton, GA
National Provider Identifier
1962846352
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ophthalmology Physician
- Legal business name
- AMEDCO GEORGIA LLC
- Doing business as
- Tifton Ophthalmology
- Practice address
- 1803 Old Ocilla Rd
Tifton, GA 31794-1617 - Phone
- (229) 986-2181
- Fax
- (229) 386-2193
- NPI assigned
- Apr 29, 2013
- Last updated
- Apr 29, 2013
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Erica Perreira
- Title
- Chief Operating Officer
- Phone
- (877) 881-0022
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ophthalmology Physician | 207W00000X | GA | Primary |
Addresses
Primary practice location
1803 Old Ocilla Rd
Tifton, GA 31794-1617
Mailing address
8076 W Sahara Ave
Las Vegas, NV 89117-7930
Phone (877) 881-0022
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0774710001 | Other | GA | CIGNA - GA |
| CC4435 | Other | GA | RR MEDICARE |
| GRP2612 | Other | GA | MEDICARE |
Other names 1
- Tifton Ophthalmology
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1367193600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1367193600000",
"number": "1962846352",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8076 W SAHARA AVE",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891177930",
"telephone_number": "877-881-0022",
"fax_number": "702-543-0314"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1803 OLD OCILLA RD",
"city": "TIFTON",
"state": "GA",
"postal_code": "317941617",
"telephone_number": "229-986-2181",
"fax_number": "229-386-2193"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "AMEDCO GEORGIA LLC",
"organizational_subpart": "NO",
"enumeration_date": "2013-04-29",
"last_updated": "2013-04-29",
"status": "A",
"authorized_official_last_name": "PERREIRA",
"authorized_official_first_name": "ERICA",
"authorized_official_title_or_position": "CHIEF OPERATING OFFICER",
"authorized_official_telephone_number": "877-881-0022"
},
"taxonomies": [
{
"code": "207W00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Ophthalmology",
"state": "GA",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA - GA",
"identifier": "0774710001",
"state": "GA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE",
"identifier": "CC4435",
"state": "GA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE",
"identifier": "GRP2612",
"state": "GA"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Tifton Ophthalmology",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Tifton, GA
- Allergy & Dermatology Associates of Tifton PC (Allergy, Asthma, & Sinsus Clinic)
- Allhealth Choice, LLC
- Allhealth Choice, LLC
- Raymond Alvarez, DO
- Ambitious Care Transport, LLC
- Amedisys Georgia, L.L.C. (Amedisys Home Health)
- Amerimed Pharmacy & Equipment, LLC. (AmeriMed Equipment)
- Kelsey Raney Amerson, NP
- Priscilla Amoah, MD
- Francis David Ampadu, D.O.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.