NPIMap

Organization Active NPI

Georgia Ophthalmology Referral Center, LLC

  • Ophthalmology Physician
  • Kennesaw, GA
National Provider Identifier
1174772859
Registry record updated Sep 17, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
GEORGIA OPHTHALMOLOGY REFERRAL CENTER, LLC
Practice address
1415 Wooten Lake Rd NW
Suite 130
Kennesaw, GA 30144-1336
Phone
(866) 527-3722
NPI assigned
Sep 17, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2008

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

Authorized official

Name
Rebecca A Garrett
Title
Credentialing
Phone
(678) 284-6300

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207W00000X GA Primary

Addresses

Primary practice location

1415 Wooten Lake Rd NW
Suite 130
Kennesaw, GA 30144-1336

Mailing address

800 Mount Vernon Hwy
Suite 120
Atlanta, GA 30328-4295
Phone (770) 804-1684

Other names 1

  • Woolfson Eye Institute, LLC Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Georgia Ophthalmology Referral Center LLC5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1221609600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1221609600000",
    "number": "1174772859",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 MOUNT VERNON HWY",
            "address_2": "SUITE 120",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303284295",
            "telephone_number": "770-804-1684"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1415 WOOTEN LAKE RD NW",
            "address_2": "SUITE 130",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301441336",
            "telephone_number": "866-527-3722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GEORGIA OPHTHALMOLOGY REFERRAL CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-17",
        "last_updated": "2008-09-17",
        "status": "A",
        "authorized_official_last_name": "GARRETT",
        "authorized_official_first_name": "REBECCA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CREDENTIALING",
        "authorized_official_telephone_number": "678-284-6300"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "GA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Woolfson Eye Institute, LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Kennesaw, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 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.

Verify at the official NPI Registry.