Mountain Eye Clinic, PC

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPT001389 Issued in GA

Legal business name

MOUNTAIN EYE CLINIC, PC

Practice address

431 Grove St N
Suite C
Dahlonega, GA 30533-0437

Phone

(706) 864-8635

Fax

(706) 864-2441

NPI assigned

Jun 6, 2008

Organization subpart

No

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

Authorized official

Name

Mr. Richard G Jabaley, O.D.NPI 1033264510

Title

Optometrist/Owner

Phone

(706) 864-8635

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Richard Gerard Jabaley, O.D.

  • Optometrist
  • Dahlonega, GA
  • NPI 1033264510
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1212710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1361923200000",
    "number": "1073772828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "431 GROVE ST N",
            "address_2": "SUITE C",
            "city": "DAHLONEGA",
            "state": "GA",
            "postal_code": "305330437",
            "telephone_number": "706-864-8635",
            "fax_number": "706-864-2441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "431 GROVE ST N",
            "address_2": "SUITE C",
            "city": "DAHLONEGA",
            "state": "GA",
            "postal_code": "305330437",
            "telephone_number": "706-864-8635",
            "fax_number": "706-864-2441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOUNTAIN EYE CLINIC, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-06",
        "last_updated": "2013-02-27",
        "status": "A",
        "authorized_official_last_name": "JABALEY",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "OPTOMETRIST/OWNER",
        "authorized_official_telephone_number": "706-864-8635",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "GA",
            "license": "OPT001389",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000712269A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amy Lord Mitton, NP-C
• MJRR LLC
• Mark D. Moers, M.D.
• Mehrdad Moghaddari, DDS
• Alice Moore, RPH
• Mt. Sinai Wellness Center, LLC
• Michael Jacob Mulberry, MD
• Caroline Marie Muller, CPNP-PC, RN
• Mullins Pharmacy
• Eric L Mullins

• Optometrist in Dahlonega, GA
• Providers in Dahlonega, GA by specialty
• Optometrist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.