Active NPI
Maurice Joseph, OD
- Optometrist
- Atlanta, GA
National Provider Identifier
1104022870
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 821-T
- Practice address
- 6350 Peachtree Dunwoody Rd. NE
Atlanta, GA 30328-1009 - Phone
- (770) 351-8995
- Fax
- (770) 688-1903
- NPI assigned
- Jun 21, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 821-T | GA | Primary |
Addresses
Primary practice location
6350 Peachtree Dunwoody Rd. NE
Atlanta, GA 30328-1009
Mailing address
6350 Peachtree Dunwoody Rd.
Atlanta, GA 30328-1009
Phone (770) 351-8995
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 821-T | Other | GA | LICENCE NUMBER |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 821-T | GA | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1182384000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1104022870",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6350 PEACHTREE DUNWOODY RD.",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303281009",
"telephone_number": "770-351-8995",
"fax_number": "770-688-1903"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6350 PEACHTREE DUNWOODY RD. NE",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303281009",
"telephone_number": "770-351-8995",
"fax_number": "770-688-1903"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOSEPH",
"first_name": "MAURICE",
"name_prefix": "Dr.",
"credential": "OD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-06-21",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "GA",
"license": "821-T",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENCE NUMBER",
"identifier": "821-T",
"state": "GA"
}
],
"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 Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.