NPIMap

Organization Active NPI

Woodstock Vision Center, Inc.

  • Optometrist
  • Woodstock, GA
National Provider Identifier
1063650422
Registry record updated Jan 22, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1072 Issued in GA
Legal business name
WOODSTOCK VISION CENTER, INC.
Practice address
9801 Highway 92
Suite 100
Woodstock, GA 30188-6453
Phone
(770) 592-7400
NPI assigned
Jan 22, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2009

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

Authorized official

Name
Dr. Robert M Blum, O.D.
Title
Owner
Phone
(678) 457-0843

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 1072 GA Primary

Addresses

Primary practice location

9801 Highway 92
Suite 100
Woodstock, GA 30188-6453

Mailing address

9801 Highway 92
Suite 100
Woodstock, GA 30188-6453
Phone (770) 592-7400

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1232582400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1232582400000",
    "number": "1063650422",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9801 HIGHWAY 92",
            "address_2": "SUITE 100",
            "city": "WOODSTOCK",
            "state": "GA",
            "postal_code": "301886453",
            "telephone_number": "770-592-7400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9801 HIGHWAY 92",
            "address_2": "SUITE 100",
            "city": "WOODSTOCK",
            "state": "GA",
            "postal_code": "301886453",
            "telephone_number": "770-592-7400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WOODSTOCK VISION CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-01-22",
        "last_updated": "2009-01-22",
        "status": "A",
        "authorized_official_last_name": "BLUM",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "678-457-0843",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "GA",
            "license": "1072",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodstock, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2009; 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.