NPIMap

Organization Active NPI

Suresight and Associates L L C

  • Optometrist
  • Canton, GA
National Provider Identifier
1063680833
Registry record updated Apr 2, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT0001624 Issued in GA
Legal business name
SURESIGHT AND ASSOCIATES L L C
Doing business as
SURESIGHT EYECARE CANTON
Practice address
217 Riverstone Dr
Canton, GA 30114-5256
Phone
(770) 345-5220
Fax
(770) 479-5011
NPI assigned
Feb 14, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2009

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

Authorized official

Name
Dr. David Jackson Wayland Sr., O.D.
Title
President
Phone
(770) 345-5220

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X OPT0001624 GA Primary
Ophthalmologic Surgery Clinic/Center 261QS0132X GA1769 GA

Addresses

Primary practice location

217 Riverstone Dr
Canton, GA 30114-5256

Mailing address

217 Riverstone Dr
Canton, GA 30114-5256
Phone (770) 345-5220

Other names 1

  • SURESIGHT EYECARE CANTON Doing business as

National Provider Directory

National Provider Directory

Locations

217 Riverstone Dr
Canton, GA 30114
Phone (770) 345-5220

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": "1202947200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1238630400000",
    "number": "1063680833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "217 RIVERSTONE DR",
            "city": "CANTON",
            "state": "GA",
            "postal_code": "301145256",
            "telephone_number": "770-345-5220",
            "fax_number": "770-479-5011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "217 RIVERSTONE DR",
            "city": "CANTON",
            "state": "GA",
            "postal_code": "301145256",
            "telephone_number": "770-345-5220",
            "fax_number": "770-479-5011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SURESIGHT AND ASSOCIATES L L C",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-14",
        "last_updated": "2009-04-02",
        "status": "A",
        "authorized_official_last_name": "WAYLAND",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "JACKSON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "770-345-5220",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Sr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "GA",
            "license": "OPT0001624",
            "primary": true
        },
        {
            "code": "261QS0132X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ophthalmologic Surgery",
            "state": "GA",
            "license": "GA1769",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SURESIGHT EYECARE CANTON",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Canton, GA

Sources for this page

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