Organization Active NPI

B.Dean Mobley, O.D., P.C.

Doing business as Mobley Eye Care

  • Optometrist
  • Austell, GA
National Provider Identifier
1194995175
Registry record updated Aug 6, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT000912 Issued in GA
Legal business name
B.DEAN MOBLEY, O.D., P.C.
Doing business as
Mobley Eye Care
Practice address
3999 Austell Rd
Suite 1002
Austell, GA 30106-1100
Phone
(770) 941-2323
Fax
(770) 941-9220
NPI assigned
Mar 6, 2008
Last updated
Aug 6, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2011

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

Authorized official

Name
Angel Haynes
Title
Office Manager
Phone
(770) 941-2323

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPT000912 GA Primary

Addresses

Primary practice location

3999 Austell Rd
Suite 1002
Austell, GA 30106-1100

Mailing address

3999 Austell Rd
Suite 1002
Austell, GA 30106-1100
Phone (770) 941-2323

Other identifiers 1

IdentifierTypeStateIssuer
00214629AMedicaidGA

Other names 1

  • MOBLEY EYE CARE Doing business as

National Provider Directory

National Provider Directory

Locations

2345 E West Connector
#1010
Austell, GA 30106
Phone (770) 941-2323

3999 Austell Rd
Ste 1002
Austell, GA 30106
Phone (770) 941-2323

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1204761600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1312588800000",
    "number": "1194995175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3999 AUSTELL RD",
            "address_2": "SUITE 1002",
            "city": "AUSTELL",
            "state": "GA",
            "postal_code": "301061100",
            "telephone_number": "770-941-2323",
            "fax_number": "770-941-9220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3999 AUSTELL RD",
            "address_2": "SUITE 1002",
            "city": "AUSTELL",
            "state": "GA",
            "postal_code": "301061100",
            "telephone_number": "770-941-2323",
            "fax_number": "770-941-9220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "B.DEAN MOBLEY, O.D., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-06",
        "last_updated": "2011-08-06",
        "status": "A",
        "authorized_official_last_name": "HAYNES",
        "authorized_official_first_name": "ANGEL",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "770-941-2323"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "GA",
            "license": "OPT000912",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00214629A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MOBLEY EYE CARE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Austell, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2011; 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.