Individual provider Active NPI

Erin Melissa Jones, OD

  • Optometrist
  • Jefferson, GA
National Provider Identifier
1134327158
Registry record updated Jan 31, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT002389 Issued in GA
Practice address
1681 Old Pendergrass Rd
Suite 170
Jefferson, GA 30549-2718
Phone
(706) 387-0111
Fax
(706) 366-1290
NPI assigned
Jul 11, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPT002389 GA Primary
Optometrist 152W00000X 1480 SC

Addresses

Primary practice location

1681 Old Pendergrass Rd
Suite 170
Jefferson, GA 30549-2718

Mailing address

930 Hiram Davis Rd
Lawrenceville, GA 30045-7267
Phone (404) 323-0176

Other identifiers 1

IdentifierTypeStateIssuer
1134327158MedicaidGA

Medicare participation

Medicare enrollment files
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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071218000294 GA Practitioner - Optometry 9931299682 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1681 Old Pendergrass Rd
Suite 170
Jefferson, GA 30549-2720
Phone (706) 387-0111

1681 Old Pengergrass Rd
Suite 170
Jefferson, GA 30549
Phone (706) 387-0111

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery14

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPT002389GAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Erin Melissa Jones, PC Optometrist CurrentSince Oct 25, 2010 Accepting new patients
North Georgia Eye Care LLC Past Accepting new patients

Locations

1681 Old Pendergrass Rd
Ste 170
Jefferson, GA 30549
Phone (706) 387-0111

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1184112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1327968000000",
    "number": "1134327158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "930 HIRAM DAVIS RD",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300457267",
            "telephone_number": "404-323-0176"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1681 OLD PENDERGRASS RD",
            "address_2": "SUITE 170",
            "city": "JEFFERSON",
            "state": "GA",
            "postal_code": "305492718",
            "telephone_number": "706-387-0111",
            "fax_number": "706-366-1290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JONES",
        "first_name": "ERIN",
        "middle_name": "MELISSA",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-11",
        "last_updated": "2012-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "GA",
            "license": "OPT002389",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "SC",
            "license": "1480",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1134327158",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jefferson, GA

Sources for this page

Verify at the official NPI Registry.