Individual provider Active NPI

Melanie P Erickson, O.D.

  • Optometrist
  • Alpharetta, GA
National Provider Identifier
1063775781
Registry record updated Sep 13, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2768 Issued in GA
Practice address
9995 Jones Bridge Rd
Alpharetta, GA 30022-6519
Phone
(770) 475-1242
NPI assigned
Jun 18, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1710 SC
Optometrist 152W00000X 2768 GA Primary

Addresses

Primary practice location

9995 Jones Bridge Rd
Alpharetta, GA 30022-6519

Mailing address

9995 Jones Bridge Rd
Alpharetta, GA 30022-6519
Phone (770) 475-1242

Other practice location 1

305 Wexwood Rd
Columbia, SC 29210-4471
Phone (803) 465-0519

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
I20130927000213 GA Practitioner - Optometry 4183858475 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Payne and Payne PCGroup PAC ID 5597666545, 5 clinicians

Practice addresses (Care Compare)

9995 Jones Bridge Rd
Alpharetta, GA 30022-6519
Phone (770) 475-1242

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery13

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2768GAMDOptometrist
1710SCMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Georgia Eye Associates, P.C. Optometrist CurrentSince Aug 20, 2013 Accepting new patients
Payne & Payne, PC Optometrist CurrentSince May 19, 2018 Accepting new patients
Urology of Greater Atlanta LLC Past Accepting new patients

Locations

9995 Jones Bridge Rd
Johns Creek, GA 30022
Phone (678) 366-1200

9995 Jones Bridge Rd
#200
Johns Creek, GA 30022
Phone (770) 475-1242

771 Old Norcross Rd
Ste 150
Lawrenceville, GA 30046
Phone (770) 995-5408

4330 Johns Creek Pkwy
Ste 300
Suwanee, GA 30024
Phone (770) 232-7844

Organizations & group practices 3

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": "1339977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536796800000",
    "number": "1063775781",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9995 JONES BRIDGE RD",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300226519",
            "telephone_number": "770-475-1242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9995 JONES BRIDGE RD",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300226519",
            "telephone_number": "770-475-1242"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "305 Wexwood Rd",
            "address_purpose": "LOCATION",
            "city": "Columbia",
            "state": "SC",
            "postal_code": "292104471",
            "country_code": "US",
            "telephone_number": "803-465-0519",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ERICKSON",
        "first_name": "MELANIE",
        "middle_name": "P",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-18",
        "last_updated": "2018-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "SC",
            "license": "1710",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "GA",
            "license": "2768",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Alpharetta, GA

Sources for this page

Verify at the official NPI Registry.