Active NPI
Michael D Hopkins, O.D.
- Optometrist
- Moultrie, GA
National Provider Identifier
1013938430
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 001331
- Practice address
- 147 Quail LN
Moultrie, GA 31788-6370 - Phone
- (229) 589-1252
- NPI assigned
- Jul 21, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 001331 | GA | Primary |
Addresses
Primary practice location
147 Quail LN
Moultrie, GA 31788-6370
Mailing address
147 Quail LN
Moultrie, GA 31788-6370
Phone (229) 589-1252
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 11582 | Other | GA | OPTICARE |
| 582233896 | Other | TRICARE | |
| 967535 | Other | GA | BLUE CROSS |
| 00520726S | Medicaid | GA | |
| 100623 | Other | GA | AVESIS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 331 | GA | MD | Marriage & Family Therapist |
| 001331 | GA | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cordele Optical Disp., Inc. | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Eyewear Supplier
- Cordele, GA
- NPI 1780850503
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153440000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1277856000000",
"number": "1013938430",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "147 QUAIL LN",
"city": "MOULTRIE",
"state": "GA",
"postal_code": "317886370",
"telephone_number": "229-589-1252"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "147 QUAIL LN",
"city": "MOULTRIE",
"state": "GA",
"postal_code": "317886370",
"telephone_number": "229-589-1252"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOPKINS",
"first_name": "MICHAEL",
"middle_name": "D",
"credential": "O.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-07-21",
"last_updated": "2010-06-30",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "GA",
"license": "001331",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OPTICARE",
"identifier": "11582",
"state": "GA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TRICARE",
"identifier": "582233896",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS",
"identifier": "967535",
"state": "GA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00520726S",
"state": "GA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AVESIS",
"identifier": "100623",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Moultrie, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.