Individual provider Active NPI

E Edward Carman, O.D.

  • Optometrist
  • Kennesaw, GA
National Provider Identifier
1144345398
Registry record updated Aug 28, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1008 Issued in GA
Practice address
1615 Ridenour Blvd NW
Suite #201
Kennesaw, GA 30152-4463
Phone
(770) 499-2020
NPI assigned
Mar 20, 2007
Last updated
Aug 28, 2013By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 28, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1008 GA Primary

Addresses

Primary practice location

1615 Ridenour Blvd NW
Suite #201
Kennesaw, GA 30152-4463

Mailing address

1615 Ridenour Blvd NW
Suite #201
Kennesaw, GA 30152-4463
Phone (770) 499-2020

Other identifiers 3

IdentifierTypeStateIssuer
581787113OtherGATAX ID FOR VSP
581787113OtherGATAX ID FOR COMPBENEFITS
581787113OtherGATAX ID FOR EYEMED

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
I20040802000338 GA Practitioner - Optometry 5092786434 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Thomas Eye Group PCGroup PAC ID 2567455868, 51 clinicians

Practice addresses (Care Compare)

600 Chastain Rd NW
Suite 312
Kennesaw, GA 30144-3047
Phone (770) 428-8090

Merit-based Incentive Payment System (MIPS)

Final score
94.51 of 100Reported as apm
Quality
80.61
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1008GAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Thomas Eye Group PC Optometrist CurrentSince Feb 19, 2024 Accepting new patients
Eecarman OD PC Optometrist CurrentSince Jun 1, 2009 Accepting new patients
Thomas Eye Group PC Optometrist Current Accepting new patients
Thomas Eye Group PC Optometrist CurrentSince Feb 19, 2024 Accepting new patients
Thomas Eye Group PC Past Accepting new patients
Optimist LLC Optometrist PastSince Mar 7, 2018 Accepting new patients

Locations

1615 Ridenour Blvd NW
Ste 201
Kennesaw, GA 30152
Phone (770) 499-2020

2700 Town Center Dr NW
Ste 100
Kennesaw, GA 30144

600 Chastain Rd NW
Ste 312
Kennesaw, GA 30144
Phone (770) 428-8090

11690 Alpharetta Hwy
Roswell, GA 30076
Phone (770) 475-5515

Interoperability endpoints

  • Direct secure messaging: eecarman@teg.emadirect.md

Organizations & group practices 6

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": "1174348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1377648000000",
    "number": "1144345398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1615 RIDENOUR BLVD NW",
            "address_2": "SUITE #201",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301524463",
            "telephone_number": "770-499-2020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1615 RIDENOUR BLVD NW",
            "address_2": "SUITE #201",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301524463",
            "telephone_number": "770-499-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARMAN",
        "first_name": "E",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-20",
        "last_updated": "2013-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "GA",
            "license": "1008",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID FOR VSP",
            "identifier": "581787113",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID FOR COMPBENEFITS",
            "identifier": "581787113",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID FOR EYEMED",
            "identifier": "581787113",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kennesaw, GA

Sources for this page

Verify at the official NPI Registry.