Individual provider Active NPI

Emily M Brown, OD

  • Optometrist
  • Hinesville, GA
National Provider Identifier
1972543932
Registry record updated Sep 24, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT002844 Issued in GA
Practice address
127 E General Screven Way
Hinesville, GA 31313-3013
Phone
(912) 877-2422
Fax
(912) 877-2430
NPI assigned
Jun 7, 2006
Last updated
Sep 24, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPT002844 GA Primary

Addresses

Primary practice location

127 E General Screven Way
Hinesville, GA 31313-3013

Mailing address

127 E General Screven Way
Hinesville, GA 31313-3013
Phone (912) 877-2422

Other identifiers 2

IdentifierTypeStateIssuer
P00181423OtherSCRAILROAD MEDICARE
D13340MedicaidSC

Other names 1

  • Emily M Walck Former name

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
I20151204000023 GA Practitioner - Optometry 2466421540 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Low Country Eye Associates, PCGroup PAC ID 8729984786, 8 clinicians

Practice addresses (Care Compare)

465 Elma G Miles Pkwy
Hinesville, GA 31313-4015
Phone (912) 877-2422

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1334SCMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Low Country Eye Associates, PC Optometrist CurrentSince Aug 25, 2015 Accepting new patients
Pee Dee Eye Associates PA Optometrist Past Accepting new patients
Marlboro Eye Care Associates, LLC Optometrist Past Accepting new patients
Southcoast Medical Group, LLC Past Accepting new patients
Pee Dee Eye Associates, PA Optometrist Past Accepting new patients

Locations

127 E General Screven Way
Hinesville, GA 31313
Phone (912) 877-2422

465 Elma G Miles Pkwy
Hinesville, GA 31313
Phone (912) 877-2422

1000 Towne Center Blvd
Ste 502
Pooler, GA 31322
Phone (912) 748-1272

1000 Gandy Dancer
Richmond Hill, GA 31324
Phone (912) 712-0132

Organizations & group practices 5

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": "1149638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1443052800000",
    "number": "1972543932",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "127 E GENERAL SCREVEN WAY",
            "city": "HINESVILLE",
            "state": "GA",
            "postal_code": "313133013",
            "telephone_number": "912-877-2422",
            "fax_number": "912-877-2430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "127 E GENERAL SCREVEN WAY",
            "city": "HINESVILLE",
            "state": "GA",
            "postal_code": "313133013",
            "telephone_number": "912-877-2422",
            "fax_number": "912-877-2430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "EMILY",
        "middle_name": "M",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-07",
        "last_updated": "2015-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "GA",
            "license": "OPT002844",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00181423",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "D13340",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "EMILY",
            "last_name": "WALCK",
            "middle_name": "M",
            "credential": "OD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Hinesville, GA

Sources for this page

Verify at the official NPI Registry.