Individual provider Active NPI

Jennifer Marie Cousins, O.D.

  • Optometrist
  • Eatonton, GA
National Provider Identifier
1194886036
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
002288 Issued in GA
Practice address
1093 Greensboro Rd
Suite 108
Eatonton, GA 31024-9505
Phone
(706) 484-2121
Fax
(706) 484-2148
NPI assigned
Dec 13, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 002288 GA Primary

Addresses

Primary practice location

1093 Greensboro Rd
Suite 108
Eatonton, GA 31024-9505

Mailing address

1093 Greensboro Rd
Suite 108
Eatonton, GA 31024-9505
Phone (706) 484-2121

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

LicenseStateTypeSpecialty
002288GAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Top Sight Optical, Inc. Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1165968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1194886036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1093 GREENSBORO RD",
            "address_2": "SUITE 108",
            "city": "EATONTON",
            "state": "GA",
            "postal_code": "310249505",
            "telephone_number": "706-484-2121",
            "fax_number": "706-484-2148"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1093 GREENSBORO RD",
            "address_2": "SUITE 108",
            "city": "EATONTON",
            "state": "GA",
            "postal_code": "310249505",
            "telephone_number": "706-484-2121",
            "fax_number": "706-484-2148"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COUSINS",
        "first_name": "JENNIFER",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "GA",
            "license": "002288",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eatonton, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.