Active NPI
Mary S Carlton, OD
- Optometrist
- Atlanta, GA
National Provider Identifier
1174599658
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 2834
- Practice address
- 1365 Clifton Rd NE
Atlanta, GA 30322-1013 - Phone
- (608) 829-5247
- NPI assigned
- Feb 24, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 2834 | WI | Primary |
Addresses
Primary practice location
1365 Clifton Rd NE
Atlanta, GA 30322-1013
Mailing address
1365 Clifton Rd NE
Atlanta, GA 30322-1013
Phone (608) 829-5247
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 38611100 | Medicaid | WI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2834 | WI | MD | Optometrist |
Interoperability endpoints
- mcarlton27654@direct.emory.org
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1140739200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1199491200000",
"number": "1174599658",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1365 CLIFTON RD NE",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303221013",
"telephone_number": "608-829-5247"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1365 CLIFTON RD NE",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303221013",
"telephone_number": "608-829-5247"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CARLTON",
"first_name": "MARY",
"middle_name": "S",
"credential": "OD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-02-24",
"last_updated": "2008-01-05",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "WI",
"license": "2834",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "38611100",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Atlanta, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.