NPIMap

Organization Active NPI

C & Y Doctors of Optometry, Inc

  • Optometrist
  • Dacula, GA
National Provider Identifier
1184340028
Registry record updated Nov 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
C & Y DOCTORS OF OPTOMETRY, INC
Doing business as
iVision eyecare
Practice address
3511 Braselton Hwy.
Ste G-200
Dacula, GA 30019-5927
Phone
(678) 916-5840
Fax
(678) 916-5844
NPI assigned
Oct 12, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2023

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

Authorized official

Name
Dr. Hae W Chun, ODNPI 1538519731
Title
Ceo
Phone
(678) 916-5840

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X Primary

Addresses

Primary practice location

3511 Braselton Hwy.
Ste G-200
Dacula, GA 30019-5927

Mailing address

3511 Braselton Hwy.
Ste G-200
Dacula, GA 30019-5927
Phone (678) 916-5840

Other names 1

  • iVision eyecare Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230213001095 GA Part B Supplier - Clinic/Group Practice 8628440013 Receives reassigned benefits from 2 practitioners
Practice locations: Dacula, GA

National Provider Directory

National Provider Directory

Locations

3511 Braselton Hwy
Ste G-200
Dacula, GA 30019
Phone (678) 916-5840

Practitioners & affiliated clinicians

Practitioners 2

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": "1665532800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1699401600000",
    "number": "1184340028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3511 BRASELTON HWY.",
            "address_2": "STE G-200",
            "city": "DACULA",
            "state": "GA",
            "postal_code": "300195927",
            "telephone_number": "678-916-5840",
            "fax_number": "678-916-5844"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3511 BRASELTON HWY.",
            "address_2": "STE G-200",
            "city": "DACULA",
            "state": "GA",
            "postal_code": "300195927",
            "telephone_number": "678-916-5840",
            "fax_number": "678-916-5844"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "C & Y DOCTORS OF OPTOMETRY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-12",
        "last_updated": "2023-11-08",
        "certification_date": "2023-11-08",
        "status": "A",
        "authorized_official_last_name": "CHUN",
        "authorized_official_first_name": "HAE",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "678-916-5840",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "iVision eyecare",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "iVision eyecare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Dacula, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2023; 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.