Individual provider Active NPI

Cindy Jeanne Williams, O.D.

  • Optometrist
  • Oxford, MS
National Provider Identifier
1033160403
Registry record updated Jul 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
000870 Issued in GA
Practice address
309 Garner Street
Oxford, MS 38655
Phone
(678) 357-3648
Fax
(770) 938-2943
NPI assigned
May 12, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 19, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPT000870 GA
Corneal and Contact Management Optometrist 152WC0802X OPT000870 GA
Optometrist 152W00000X 000870 GA Primary

Addresses

Primary practice location

309 Garner Street
Oxford, MS 38655

Mailing address

P.O. Box 1196
Oxford, MS 38655-1196
Phone (678) 357-3648

Other identifiers 12

IdentifierTypeStateIssuer
581439323OtherGACIGNA
581439323OtherGAVISION SERVICE PLAN
581439323OtherGAAVESIS
581439323OtherGAPHCS
581439323OtherGATRICARE
GA0870OtherGAEYEMED VISION
581439323OtherGAAETNA
581439323OtherGAVISION CARE PLAN
000473118AMedicaidGA
581439323OtherGAUNICARE
581439323OtherGABLUE CROSS BLUE SHIELD
581439323OtherGAFIRST HEALTH

Other names 1

  • Cindy Jeanne Stewart Former name

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20060125000033 GA Practitioner - Optometry 4486678877 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
000870GAMDMarriage & Family Therapist
OPT000870GAMDCorneal and Contact Management Optometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Myeyedr Optometry of Georgia, LLC Optometrist CurrentSince Mar 5, 2016 Accepting new patients
Myeyedr Optometry of Georgia, LLC Optometrist Current Accepting new patients
Myeyedr Optometry of Georgia, LLC Optometrist CurrentSince Mar 5, 2016 Accepting new patients
Eye 1St Holdings LLC Optometrist PastSince Oct 1, 2018 Accepting new patients

Locations

2184 Henderson Mill Rd NE
Ste 12B
Atlanta, GA 30345
Phone (770) 491-1255

2184 Henderson Mill Rd NE
#12B
Atlanta, GA 30345
Phone (770) 938-2923

4875 Altama Ave
Brunswick, GA 31520
Phone (912) 554-0010

1950 Old Gallows Rd
Ste 520
Vienna, VA 22182

8614 Westwood Center Dr
Fl 9
Vienna, VA 22182

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1147392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689724800000",
    "number": "1033160403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 1196",
            "city": "OXFORD",
            "state": "MS",
            "postal_code": "386551196",
            "telephone_number": "678-357-3648",
            "fax_number": "866-795-4020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "309 GARNER STREET",
            "city": "OXFORD",
            "state": "MS",
            "postal_code": "38655",
            "telephone_number": "678-357-3648",
            "fax_number": "770-938-2943"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "CINDY",
        "middle_name": "JEANNE",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-05-12",
        "last_updated": "2023-07-19",
        "certification_date": "2023-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "GA",
            "license": "OPT000870",
            "primary": false
        },
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "GA",
            "license": "OPT000870",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "GA",
            "license": "000870",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "581439323",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VISION SERVICE PLAN",
            "identifier": "581439323",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AVESIS",
            "identifier": "581439323",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHCS",
            "identifier": "581439323",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "581439323",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EYEMED VISION",
            "identifier": "GA0870",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "581439323",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VISION CARE PLAN",
            "identifier": "581439323",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000473118A",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNICARE",
            "identifier": "581439323",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "581439323",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST HEALTH",
            "identifier": "581439323",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CINDY",
            "last_name": "STEWART",
            "middle_name": "JEANNE",
            "credential": "O.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Oxford, MS

Sources for this page

Verify at the official NPI Registry.