Peachtree Corners Eye Clinic

Primary specialty

OptometristTaxonomy code 152W00000X

License

001461T Issued in GA

Legal business name

PEACHTREE CORNERS EYE CLINIC

Practice address

4045 Wetherburn Way
Suite
Norcross, GA 30092-4661

Phone

(770) 441-1211

Fax

(770) 448-9141

NPI assigned

Sep 18, 2012

Last updated

Sep 18, 2012By the provider in NPPES

Organization subpart

Yes

Parent organization

PEACHTREE CORNERS EYE CLINICAs reported in NPPES

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

Authorized official

Name

Richard J Shuster, O.D.

Title

Owner

Phone

(770) 441-1211

Specialties & licenses 1

Addresses

Part of

Peachtree Corners Eye Clinic

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Michael K Choi, O.D.

  • Optometrist
  • Peachtree Corners, GA
  • NPI 1710471370
  NPD (past)

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

{
    "created_epoch": "1347926400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1347926400000",
    "number": "1164772042",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4045 WETHERBURN WAY",
            "address_2": "SUITE 1",
            "city": "NORCROSS",
            "state": "GA",
            "postal_code": "300924661",
            "telephone_number": "770-441-1211",
            "fax_number": "770-448-9141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4045 WETHERBURN WAY",
            "address_2": "SUITE",
            "city": "NORCROSS",
            "state": "GA",
            "postal_code": "300924661",
            "telephone_number": "770-441-1211",
            "fax_number": "770-448-9141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEACHTREE CORNERS EYE CLINIC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PEACHTREE CORNERS EYE CLINIC",
        "enumeration_date": "2012-09-18",
        "last_updated": "2012-09-18",
        "status": "A",
        "authorized_official_last_name": "SHUSTER",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "770-441-1211",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "GA",
            "license": "001461T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brendon Paul, APRN, PMHNP-BC
• Claire Camille Pavlich, PT, DPT
• PCH Services Inc (Kamara Extreme Care)
• Pcti
• Peachtree Corners Chiropractic Clinic
• Peachtree Diagnostic Laboratories Inc
• Peachtree Ophthalmology LLC
• Peachtree Rapidcare Medical Center Inc
• Peachtree Recovery Solutions
• Peachtree Surgical Associates

• Optometrist in Norcross, GA
• Providers in Norcross, GA by specialty
• Optometrist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2012; 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.