Optometry Clinic, Inc.

Primary specialty

OptometristTaxonomy code 152W00000X

License

GA OPT1868 Issued in GA

Legal business name

OPTOMETRY CLINIC, INC.

Practice address

9220 Marne Rd
Fort Benning, GA 31905-5515

Phone

(706) 682-3938

Fax

(706) 682-3931

NPI assigned

Mar 9, 2009

Last updated

Aug 23, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Smitesh Jay PatelNPI 1134103021

Title

President

Phone

(706) 507-3937

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Smitesh Jay Patel, O.D.

  • Optometrist
  • Fort Benning, GA
  • NPI 1134103021
  Authorized official Same address or phone
• Robin Rae Chandler-Morgan, O.D.

  • Optometrist
  • Americus, GA
  • NPI 1215023809
  NPD (past)

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

{
    "created_epoch": "1236556800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1661212800000",
    "number": "1083855704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "312 CASCADE CT",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "319042805",
            "telephone_number": "706-593-0709",
            "fax_number": "706-682-3931"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9220 MARNE RD",
            "city": "FORT BENNING",
            "state": "GA",
            "postal_code": "319055515",
            "telephone_number": "706-682-3938",
            "fax_number": "706-682-3931"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPTOMETRY CLINIC, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-03-09",
        "last_updated": "2022-08-23",
        "certification_date": "2022-08-23",
        "status": "A",
        "authorized_official_last_name": "PATEL",
        "authorized_official_first_name": "SMITESH",
        "authorized_official_middle_name": "JAY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "706-507-3937",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "GA",
            "license": "GA OPT1868",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "404896730A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jennifer Nicole O'Connor, RN
• Samuel O'Garro, PA STUDENT
• Autumn Marie Oakley, ATC
• Hannah Ohara
• Shaylee Olive, LICSW
• Gustavo Ortiz, PTA
• Safrona Osbeck, PSY.D.
• Michael Scott Osborne, PH.D., LPC, NCC
• Crystal J Owens
• Myung Park

• Optometrist in Fort Benning, GA
• Providers in Fort Benning, GA by specialty
• Optometrist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2022; 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.