Individual provider Active NPI

Christopher Michael O'Brien, O.D.

  • Optometrist
  • Atlanta, GA
National Provider Identifier
1043487143
Registry record updated Aug 2, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1895 Issued in GA
Practice address
1140 Hammond Dr
BLDG E Suite 5100
Atlanta, GA 30328-5338
Phone
(770) 394-4000
Fax
(770) 913-0841
NPI assigned
May 8, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2013

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 006248 NY
Optometrist 152W00000X 11832 CA
Optometrist 152W00000X 1895 GA Primary
Optometrist 152W00000X 27OA00601800 NJ
Optometrist 152W00000X 002704 CT

Addresses

Primary practice location

1140 Hammond Dr
BLDG E Suite 5100
Atlanta, GA 30328-5338

Mailing address

871 Penn Ave NE
Atlanta, GA 30309-4228
Phone (914) 472-3937

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

LicenseStateTypeSpecialty
002704CTMDOptometrist
27OA00601800NJMDOptometrist
006248NYMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Woodhams Laser & Lens Implant Center LLC 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.

NPI Registry JSON

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

{
    "created_epoch": "1210204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1375401600000",
    "number": "1043487143",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "871 PENN AVE NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303094228",
            "telephone_number": "914-472-3937",
            "fax_number": "770-913-0841"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1140 HAMMOND DR",
            "address_2": "BLDG E SUITE 5100",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303285338",
            "telephone_number": "770-394-4000",
            "fax_number": "770-913-0841"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'BRIEN",
        "first_name": "CHRISTOPHER",
        "middle_name": "MICHAEL",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-05-08",
        "last_updated": "2013-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "006248",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "11832",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "GA",
            "license": "1895",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NJ",
            "license": "27OA00601800",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CT",
            "license": "002704",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2013; 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.