Kofi Oteng Gyang, O.D

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPT1481 Issued in GA

Practice address

1525 E Park Place Blvd
#1100,
Stone Mountain, GA 30087-3453

Phone

(770) 498-3434

NPI assigned

Jan 19, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

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.

• Mark Lynn OD & Associates, PC

  • Optometrist
  • Lithonia, GA
  • NPI 1417055203
  Medicare reassignment NPD
• Stone Mountain Eye Center

  • Clinic/Center
  • Stone Mountain, GA
  • NPI 1528228616
  Medicare reassignment NPD
• KG Family Eye Clinic PC

  • Optometrist
  • Morrow, GA
  • NPI 1568353373
  NPD Authorized official
• Mark Lynn O.D. & Associates, PC

  • Eyewear Supplier
  • Savannah, GA
  • NPI 1518375500
  NPD

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

{
    "created_epoch": "1169164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1144373267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1525 E PARK PLACE BLVD",
            "address_2": "#1100,",
            "city": "STONE MOUNTAIN",
            "state": "GA",
            "postal_code": "300873453",
            "telephone_number": "770-498-3434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1525 E PARK PLACE BLVD",
            "address_2": "#1100,",
            "city": "STONE MOUNTAIN",
            "state": "GA",
            "postal_code": "300873453",
            "telephone_number": "770-498-3434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OTENG GYANG",
        "first_name": "KOFI",
        "name_prefix": "Dr.",
        "credential": "O.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "GA",
            "license": "OPT1481",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00662494B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Carmen Orizabal
• Chante Orsborn
• Odion Patience Osayimwen, NP
• Danielle Oswald
• Nnenna Beatrice Otaluka, NP
• Stephanie L Overton
• Lavonna Winfreda Owens-Jackson, LPC, CCM
• Beverli Simone Owens, LAT, ATC
• Melvin Douglas Owens, DOCTOR OF PHARMACY
• Jonathan Pace, EMT-I

• Optometrist in Stone Mountain, GA
• Providers in Stone Mountain, GA by specialty
• Optometrist in Georgia

• 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.
• 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.