Organization Active NPI

Primary Eyecare

  • Optometrist
  • Warner Robins, GA
National Provider Identifier
1114110574
Registry record updated Jan 3, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
PRIMARY EYECARE
Practice address
627 S Houston Lake Rd
Suite 100
Warner Robins, GA 31088-9077
Phone
(478) 322-0009
NPI assigned
Aug 20, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2008

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

Authorized official

Name
Leta M Bird
Title
Blling Manager
Phone
(478) 475-1600

Specialties & licenses 1

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

Addresses

Primary practice location

627 S Houston Lake Rd
Suite 100
Warner Robins, GA 31088-9077

Mailing address

3801 Northsdie Dr
Macon, GA 31201
Phone (478) 475-1600

National Provider Directory

National Provider Directory

Locations

627 S Houston Lake Rd
Ste 100
Warner Robins, GA 31088
Phone (478) 322-0009

Practitioners & affiliated clinicians

Practitioners 2

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": "1187568000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1199318400000",
    "number": "1114110574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3801 NORTHSDIE DR",
            "city": "MACON",
            "state": "GA",
            "postal_code": "31201",
            "telephone_number": "478-475-1600",
            "fax_number": "478-475-4160"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "627 S HOUSTON LAKE RD",
            "address_2": "SUITE 100",
            "city": "WARNER ROBINS",
            "state": "GA",
            "postal_code": "310889077",
            "telephone_number": "478-322-0009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIMARY EYECARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-20",
        "last_updated": "2008-01-03",
        "status": "A",
        "authorized_official_last_name": "BIRD",
        "authorized_official_first_name": "LETA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "BLLING MANAGER",
        "authorized_official_telephone_number": "478-475-1600"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Warner Robins, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2008; 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.