NPIMap

Organization Active NPI

Woodhams Laser & Lens Implant Center LLC

  • Ambulatory Surgical Clinic/Center
  • Atlanta, GA
National Provider Identifier
1093748527
Registry record updated Nov 18, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
Legal business name
WOODHAMS LASER & LENS IMPLANT CENTER LLC
Practice address
1140 Hammond Dr NE
E5100
Atlanta, GA 30328-5338
Phone
(770) 394-4000
Fax
(770) 913-0841
NPI assigned
Jul 8, 2006
Last updated
Nov 18, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2015

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

Authorized official

Name
Dr. J Trevor Woodhams, MDNPI 1881652550
Title
Owner
Phone
(770) 394-4000

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X GA Primary

Addresses

Primary practice location

1140 Hammond Dr NE
E5100
Atlanta, GA 30328-5338

Mailing address

1140 Hammond Dr
E5100
Atlanta, GA 30328-5338
Phone (770) 394-4000

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120612000168 GA Part B Supplier - Clinic/Group Practice 4486818093 Receives reassigned benefits from 36 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Cumming, GA; Marietta, GA; Lawrenceville, GA; Canton, GA; Buford, GA; Atlanta, GA; Alpharetta, GA

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Care Compare: Ambulatory surgical center

Medicare Care Compare
Listed as
Woodhams Laser and Lens Implant Center LLCCCN 11C0001209
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory
Tax ID family
Atlanta Anesthesia Consultants LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

201 Kimberly Way
Ste 104
Canton, GA 30114

970 Sanders Rd
Ste 100
Cumming, GA 30041

6105 Peachtree Dunwoody Rd
Ste 100
Sandy Springs, GA 30328
Phone (770) 394-4000

Practitioners & affiliated clinicians

Practitioners 43

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.

View all 43

NPI Registry JSON

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

{
    "created_epoch": "1152316800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1447804800000",
    "number": "1093748527",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1140 HAMMOND DR",
            "address_2": "E5100",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303285338",
            "telephone_number": "770-394-4000",
            "fax_number": "770-913-0841"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1140 HAMMOND DR NE",
            "address_2": "E5100",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303285338",
            "telephone_number": "770-394-4000",
            "fax_number": "770-913-0841"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WOODHAMS LASER & LENS IMPLANT CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-08",
        "last_updated": "2015-11-18",
        "status": "A",
        "authorized_official_last_name": "WOODHAMS",
        "authorized_official_first_name": "J",
        "authorized_official_middle_name": "TREVOR",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "770-394-4000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "GA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2015; 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.