Individual provider Active NPI

Gary Brian Atkinson, O.D.

  • Optometrist
  • Athens, GA
National Provider Identifier
1164614996
Registry record updated Jan 12, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT002445 Issued in GA
Practice address
55 Carlton Street
Uga University Health Center
Athens, GA 30602-1755
Phone
(706) 542-5617
Fax
(706) 227-4763
NPI assigned
Aug 15, 2007
Last updated
Jan 12, 2011By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 12, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X S-B29-TA-734 AL
Optometrist 152W00000X OPT002445 GA Primary

Addresses

Primary practice location

55 Carlton Street
Uga University Health Center
Athens, GA 30602-1755

Mailing address

230 Kylas Way
Hull, GA 30646-3884

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
I20080410000743 GA Practitioner - Optometry 8022195312 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
S-B29-TA-734ALMDOptometrist
OPT002445GAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Board of Regents of the University System of Georgia CurrentSince Oct 1, 2013 Accepting new patients
Board of Regents of the University System of Georgia CurrentSince Oct 1, 2013 Accepting new patients
University Health Center, University of Ga Health Center Pharmacy Past Accepting new patients

Locations

110 Carlton St
Athens, GA 30602
Phone (706) 542-4598

55 Carlton St
Athens, GA 30602
Phone (706) 542-2273

Gilbert Health Ctr
Athens, GA 30602
Phone (706) 542-8720

Organizations & group practices 3

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": "1187136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1294790400000",
    "number": "1164614996",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "230 KYLAS WAY",
            "city": "HULL",
            "state": "GA",
            "postal_code": "306463884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 CARLTON STREET",
            "address_2": "UGA UNIVERSITY HEALTH CENTER",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "306021755",
            "telephone_number": "706-542-5617",
            "fax_number": "706-227-4763"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ATKINSON",
        "first_name": "GARY",
        "middle_name": "BRIAN",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-08-15",
        "last_updated": "2011-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AL",
            "license": "S-B29-TA-734",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "GA",
            "license": "OPT002445",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Athens, GA

Sources for this page

Verify at the official NPI Registry.