Chris J Coffini, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPT003569 Issued in GA

Practice address

1192 Dogwood Dr SE
Conyers, GA 30012-5454

Phone

(770) 860-1919

NPI assigned

May 12, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

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

Specialty

Optometry

Education

Pennsylvania College of Optometry, 1999

Medicare assignment

May accept Medicare assignment

Group practices

East Georgia Eyecare, LLC 3 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• East Georgia Eyecare LLC

  • Optometrist
  • Conyers, GA
  • NPI 1811024045

  GA, Optometrist

  Medicare reassignment Care Compare group NPD
• Oneopto Ga 2 PLLC

  • Optometrist
  • Conyers, GA
  • NPI 1548194731
  NPD (past)
• Shopko Stores Operating Co LLC

  • Community/Retail Pharmacy
  • Eau Claire, WI
  • NPI 1720034176
  NPD (past)

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

{
    "created_epoch": "1147392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722470400000",
    "number": "1003866682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1192 DOGWOOD DR SE",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300125454",
            "telephone_number": "770-860-1919",
            "fax_number": "770-860-1607"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1192 DOGWOOD DR SE",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300125454",
            "telephone_number": "770-860-1919"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COFFINI",
        "first_name": "CHRIS",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-12",
        "last_updated": "2024-08-01",
        "certification_date": "2024-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WI",
            "license": "2780",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "GA",
            "license": "OPT003569",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38608100",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Alison N Colquitt, AAPA

• All providers in Conyers, GA
• Optometrist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.