NPIMap

Organization Active NPI

Professional Eye Associates, Inc.

  • Eyewear Supplier
  • Fort Oglethorpe, GA
National Provider Identifier
1174988232
Registry record updated Dec 16, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Eyewear SupplierTaxonomy code 332H00000X
License
LDO001437 Issued in GA
Legal business name
PROFESSIONAL EYE ASSOCIATES, INC.
Practice address
1052 Battlefield Pkwy
Fort Oglethorpe, GA 30742-3948
Phone
(706) 226-2020
Fax
(706) 529-3322
NPI assigned
Dec 16, 2015
Organization subpart
Yes
Parent organization
PROFESSIONAL EYE ASSOCIATES, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 16, 2015

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

Authorized official

Name
Sandra Dixon Curd
Title
Chief Operations Officer
Phone
(706) 226-2020

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Eyewear Supplier 332H00000X LDO001437 GA Primary

Addresses

Primary practice location

1052 Battlefield Pkwy
Fort Oglethorpe, GA 30742-3948

Mailing address

1111 Professional Blvd
Dalton, GA 30720-2588
Phone (706) 226-2020

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20181015001142 GA DME Supplier - Optician 4789677071 Practice locations: Fort Oglethorpe, GA

Other NPIs with the same Medicare PAC ID 5

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Professional Eye Associates6 organizations share this tax ID, including this one
Part of
Professional Eye Associates

Other organizations with this tax ID 5

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

Practitioners & affiliated clinicians

Practitioners 7

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": "1450224000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1450224000000",
    "number": "1174988232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 PROFESSIONAL BLVD",
            "city": "DALTON",
            "state": "GA",
            "postal_code": "307202588",
            "telephone_number": "706-226-2020",
            "fax_number": "706-529-3322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1052 BATTLEFIELD PKWY",
            "city": "FORT OGLETHORPE",
            "state": "GA",
            "postal_code": "307423948",
            "telephone_number": "706-226-2020",
            "fax_number": "706-529-3322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROFESSIONAL EYE ASSOCIATES, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PROFESSIONAL EYE ASSOCIATES, INC.",
        "enumeration_date": "2015-12-16",
        "last_updated": "2015-12-16",
        "status": "A",
        "authorized_official_last_name": "CURD",
        "authorized_official_first_name": "SANDRA",
        "authorized_official_middle_name": "DIXON",
        "authorized_official_title_or_position": "CHIEF OPERATIONS OFFICER",
        "authorized_official_telephone_number": "706-226-2020"
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "GA",
            "license": "LDO001437",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Oglethorpe, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.