Organization Active NPI

Eyedeal Eyecare LLC

  • Optometrist
  • Austell, GA
National Provider Identifier
1093361404
Registry record updated May 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
EYEDEAL EYECARE LLC
Practice address
1133 E West Connector
Austell, GA 30106-1779
Phone
(770) 863-9421
NPI assigned
Aug 12, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 26, 2025

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

Authorized official

Name
Dr. Janis James, OD
Title
Owner
Phone
(770) 863-9421

Specialties & licenses 1

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

Addresses

Primary practice location

1133 E West Connector
Austell, GA 30106-1779

Mailing address

1133 E West Connector
Austell, GA 30106-1779

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20191105002930 GA Part B Supplier - Clinic/Group Practice 6103158431 Receives reassigned benefits from 1 practitioner
Practice locations: Austell, GA

National Provider Directory

National Provider Directory

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": "1565568000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1748217600000",
    "number": "1093361404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1133 E WEST CONNECTOR",
            "city": "AUSTELL",
            "state": "GA",
            "postal_code": "301061779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1133 E WEST CONNECTOR",
            "city": "AUSTELL",
            "state": "GA",
            "postal_code": "301061779",
            "telephone_number": "770-863-9421"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYEDEAL EYECARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-08-12",
        "last_updated": "2025-05-26",
        "certification_date": "2025-05-26",
        "status": "A",
        "authorized_official_last_name": "JAMES",
        "authorized_official_first_name": "JANIS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "770-863-9421",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austell, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.