NPIMap

Organization Active NPI

Family First Vision Care Georgia PLLC

  • Optometrist
  • Canton, GA
National Provider Identifier
1003675893
Registry record updated Mar 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
FAMILY FIRST VISION CARE GEORGIA PLLC
Practice address
1455 Riverstone Pkwy Ste 110
Canton, GA 30114-5627
Phone
(770) 479-0500
NPI assigned
Mar 15, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2024

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

Authorized official

Name
Krystal Van Dresar
Title
Director of Revenue Cycle Managemen
Phone
(817) 757-3225

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X Primary

Addresses

Primary practice location

1455 Riverstone Pkwy Ste 110
Canton, GA 30114-5627

Mailing address

PO Box 631665
Cincinnati, OH 45263-1665
Phone (817) 757-3225

Other names 1

  • Pearle Vision Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Family First Vision Care Georgia6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1710460800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1710460800000",
    "number": "1003675893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 631665",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452631665",
            "telephone_number": "817-757-3225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1455 RIVERSTONE PKWY STE 110",
            "city": "CANTON",
            "state": "GA",
            "postal_code": "301145627",
            "telephone_number": "770-479-0500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY FIRST VISION CARE GEORGIA PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-03-15",
        "last_updated": "2024-03-15",
        "certification_date": "2024-03-15",
        "status": "A",
        "authorized_official_last_name": "VAN DRESAR",
        "authorized_official_first_name": "KRYSTAL",
        "authorized_official_title_or_position": "DIRECTOR OF REVENUE CYCLE MANAGEMEN",
        "authorized_official_telephone_number": "817-757-3225"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pearle Vision",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Canton, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.