GEORGIA EYE INSTITUTE OF THE SOUTHEAST, LLC (NPI# 1154714574) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154714574 |
| Entity Type | Organization |
| Organization Name | GEORGIA EYE INSTITUTE OF THE SOUTHEAST, LLC |
| Practice Address |
104 Andrews Street, Suite 112 Vidalia GA 30474 |
| Mailing Address |
4720 Waters Ave Savannah GA 31404-6292 |
| Practice Telephone | 9125374447 |
| Practice Fax Number | 9125372743 |
| Mailing Telephone | 9123544800 |
| Mailing Fax Number | 9126295821 |
| Enumeration Date | 2015-03-10 |
| Last Update Date | 2015-04-17 |
| Authorized Official Name | KATHY HEGAN (PRACTICE ADMINISTRARTOR) |
| Authorized Official Telephone | 9126295929 |
| Is Organization Subpart | Y |
| Parent Organization Name | GEORGIA EYE INSTITUTE OF THE SOUTHEAST, LLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 152W00000X | Optometrist | Eye and Vision Services Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124519954 | Georgia Eye Institute of The Southeast, LLC | Ophthalmology | 1000 Towne Center Blvd Ste 806, Pooler, GA 31322-4070 | 2018-05-29 |
| 1639410756 | Georgia Eye Institute of The Southeast, LLC | Optometrist | 741 Weeping Willow Drive, Hinesville, GA 31313 | 2013-03-14 |
| 1992058234 | Georgia Eye Institute of The Southeast, LLC | Optometrist | 3303 Glynn Avenue, Brunswick, GA 31520-4406 | 2012-10-24 |
| 1417200148 | Georgia Eye Institute of The Southeast, LLC | Ophthalmology | 80 Baylor Way, Bluffton, SC 29910-8902 | 2012-10-18 |
| 1144474016 | Georgia Eye Institute of The Southeast, LLC | Ophthalmology | 6162 Hwy 21 South, Rincon, GA 31326-5164 | 2008-11-05 |
| 1619121589 | Georgia Eye Institute of The Southeast, LLC | Ophthalmology | 2429 Us Highway 17, Richmond Hill, GA 31324-3397 | 2008-11-05 |
| 1750535621 | Georgia Eye Institute of The Southeast, LLC | Ophthalmology | 4 Okatie Center Blvd. Ste. 102, Okatie, SC 29909 | 2008-11-05 |
| 1508119207 | Georgia Eye Institute of The Southeast, LLC | Optometrist | 1000 Towne Center Blvd, Pooler, GA 31322-4052 | 2012-10-18 |
| 1386997013 | Georgia Eye Institute of The Southeast, LLC | Optometrist | 198 Sw Broad St, Jesup, GA 31545-1101 | 2012-10-18 |
| 1275885279 | Georgia Eye Institute of The Southeast, LLC | Ophthalmology | 445 S Main St, Suite 104, Hinesville, GA 31313-4333 | 2012-10-15 |
| Street Address |
104 ANDREWS STREET, SUITE 112 |
| City | VIDALIA |
| State | GA |
| Zip Code | 30474 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730655374 | Abby Virginia Adams | Speech-Language Pathologist | 101 Harris Insustrial Blvd, Vidalia, GA 30474 | 2018-10-22 |
| 1467930156 | Laurel Shiver Sapp | Nurse Practitioner | 1608 Meadows Ln, Vidalia, GA 30474 | 2018-08-03 |
| 1235658931 | Mary Frances Andrews | Nurse Practitioner | 1608 Meadows Lane Suite 1, Vidalia, GA 30474 | 2017-09-13 |
| 1790112571 | Tattnall Hospital Company, LLC | Surgery | 1702-a Meadows Lane, Vidalia, GA 30474 | 2013-10-10 |
| 1801235312 | Paul Anderson Youth Home, Inc. | Substance Abuse Rehabilitation Facility | 1603 Mcintosh Street, Vidalia, GA 30474 | 2013-06-18 |
| 1043591076 | Kimberly Thigpen Evans | Nurse Practitioner | 621 East First Street, Unit B, Vidalia, GA 30474 | 2011-09-03 |
| 1154614360 | Tattnall Hospital Company, LLC | Family Medicine | 1811 Edwina Drive, Vidalia, GA 30474 | 2011-05-20 |
| 1255586053 | Vidalia Medical Partners Inc. | Home Health | 801 Mcnatt Street, Vidalia, GA 30474 | 2008-11-20 |
| 1154596419 | Jill Nicole Lawrence | Speech-Language Pathologist | 1400 Ne Main St, Bethany Alf, Vidalia, GA 30474 | 2008-04-28 |
| 1871714600 | John Holmes Talton | Dentist | 316a Maple Drive, Vidalia, GA 30474 | 2007-05-01 |
| Find all providers in zip 30474 | ||||
| Taxonomy Code | 152W00000X |
| Grouping | Eye and Vision Services Providers |
| Classification | Optometrist |
| Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system. |
| Notes: Source: American Optometric Association (AOA), approved by the AOA’s Board of Trustees, June 21, 2005. [7/1/2006: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811262678 | Georgia Optical | Optometrist | 3173 E 1st St, Vidalia, GA 30474-8830 | 2012-03-13 |
| 1043385172 | Optometry Associates, PC | Optometrist | 300 Durden St, Vidalia, GA 30474-4606 | 2006-11-22 |
| 1073688115 | Lyn Brown Oxley | Optometrist | 104 Andrew St Ste 112, Vidalia, GA 30474-7241 | 2006-11-22 |
| 1568936151 | Vidalia Eyecare LLC | Optometrist | 206 Maple Dr, Vidalia, GA 30474-8907 | 2019-01-16 |
| 1902155393 | Doo Yeon Kang | Optometrist | 206 Maple Dr, Vidalia, GA 30474 | 2012-08-31 |
| 1174706642 | Darel C. Edwards, P.C. | Optometrist | 206 Maple Dr, Vidalia, GA 30474-8907 | 2007-12-07 |
| 1215129531 | David S. Edmonds Od PC | Optometrist | 3109 E 1st St, Vidalia, GA 30474-8830 | 2007-08-10 |
| 1235343807 | Georgia Eye Institute, Inc. | Optometrist | 206 Maple Dr, Vidalia, GA 30474-8907 | 2007-05-10 |
| 1841317336 | Ronald B. Yancey, P.C. | Optometrist | 303 Harris Industrial Blvd., Suite 7, Vidalia, GA 30474-4752 | 2007-03-22 |
| 1518034651 | Georgia Eye Institute, Inc. | Optometrist | 300 Durden St, Vidalia, GA 30474-4606 | 2006-11-30 |
| Find all providers in VIDALIA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.