Edward Theodore Washington Jr.

Primary specialty

Glaucoma Specialist (Ophthalmology) PhysicianTaxonomy code 207WX0009X

License

91739 Issued in GA

Practice address

4045 Wetherburn Way Ste 1
Norcross, GA 30092-4611

Phone

(770) 285-7910

NPI assigned

Apr 5, 2015

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Peachtree Ophthalmology LLC

  • Ophthalmology Physician
  • Norcross, GA
  • NPI 1285328849
  Medicare reassignment NPD Authorized official
• Marietta Eye Clinic PA

  • Ophthalmology Physician
  • Suwanee, GA
  • NPI 1700675568
  Medicare reassignment NPD
• Marietta Eye Clinic PA

  • Ophthalmologic Surgery Clinic/Center
  • Suwanee, GA
  • NPI 1225836869
  NPD
• Marietta Eye Clinic, PA

  • Ophthalmology Physician
  • Marietta, GA
  • NPI 1447469507
  NPD

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

{
    "created_epoch": "1428192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693353600000",
    "number": "1104211283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4045 WETHERBURN WAY STE 1",
            "city": "NORCROSS",
            "state": "GA",
            "postal_code": "300924611",
            "telephone_number": "770-285-7010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4045 WETHERBURN WAY STE 1",
            "city": "NORCROSS",
            "state": "GA",
            "postal_code": "300924611",
            "telephone_number": "770-285-7910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WASHINGTON",
        "first_name": "EDWARD",
        "middle_name": "THEODORE",
        "name_suffix": "Jr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-04-05",
        "last_updated": "2023-08-30",
        "certification_date": "2023-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "LA",
            "license": "312393",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "OH",
            "license": "57027483",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "KY",
            "license": "TP126",
            "primary": false
        },
        {
            "code": "207WX0009X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Glaucoma Specialist",
            "state": "GA",
            "license": "91739",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300039071",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100669250",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lizhen Wang, MD
• Soo Hyun Wang, PT, DPT
• Tong Wang
• Lina Warda
• Warrior EMS LLC
• Sade Cheryll Washington
• Clarice Whitlock Wasmuth, RN-CS, ANP
• Martina Watson
• Tatiana Watson
• Ursula Alice Watson, MD

• Glaucoma Specialist (Ophthalmology) Physician in Norcross, GA
• Providers in Norcross, GA by specialty
• Glaucoma Specialist (Ophthalmology) Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.