Organization Active NPI

Gwinnett Urgent Eye Care Clinic PC

  • Urgent Care Clinic/Center
  • Duluth, GA
National Provider Identifier
1013786458
Registry record updated Jan 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urgent Care Clinic/CenterTaxonomy code 261QU0200X
Legal business name
GWINNETT URGENT EYE CARE CLINIC PC
Practice address
3840 Peachtree Industrial Blvd Ste 100
Duluth, GA 30096-5032
Phone
(678) 585-1901
Fax
(678) 691-2139
NPI assigned
Dec 27, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2024

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

Authorized official

Name
Stephen Ume, MDNPI 1558312462
Title
Owner
Phone
(678) 585-1901

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207W00000X
Urgent Care Clinic/Center 261QU0200X Primary

Addresses

Primary practice location

3840 Peachtree Industrial Blvd Ste 100
Duluth, GA 30096-5032

Mailing address

3840 Peachtree Industrial Blvd Ste 100
Duluth, GA 30096-5032
Phone (678) 585-1901

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240126003507 GA Part B Supplier - Clinic/Group Practice 1759734676 Receives reassigned benefits from 1 practitioner
Practice locations: Duluth, GA

National Provider Directory

National Provider Directory

Locations

3840 Peachtree Industrial Blvd
Ste 100
Duluth, GA 30096
Phone (678) 585-1901

Practitioners & affiliated clinicians

Practitioners 1

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": "1703635200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1705017600000",
    "number": "1013786458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3840 PEACHTREE INDUSTRIAL BLVD STE 100",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "300965032",
            "telephone_number": "678-585-1901",
            "fax_number": "678-691-2139"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3840 PEACHTREE INDUSTRIAL BLVD STE 100",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "300965032",
            "telephone_number": "678-585-1901",
            "fax_number": "678-691-2139"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GWINNETT URGENT EYE CARE CLINIC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-12-27",
        "last_updated": "2024-01-12",
        "certification_date": "2024-01-12",
        "status": "A",
        "authorized_official_last_name": "UME",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "678-585-1901",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Duluth, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.