Organization Active NPI

Pinnacle Eyecare Professionals

  • Corneal and Contact Management Optometrist
  • Snellville, GA
National Provider Identifier
1205056173
Registry record updated Jun 3, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Corneal and Contact Management OptometristTaxonomy code 152WC0802X
License
1934 Issued in GA
Legal business name
PINNACLE EYECARE PROFESSIONALS
Practice address
1520 Scenic Hwy N
Snellville, GA 30078-2130
Phone
(770) 979-2198
NPI assigned
Apr 26, 2007
Last updated
Jun 3, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2008

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

Authorized official

Name
Dr. Herman Anthony Kwong, ODNPI 1689766529
Title
President
Phone
(770) 979-2198

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
Corneal and Contact Management OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152WC0802X 1934 GA Primary

Addresses

Primary practice location

1520 Scenic Hwy N
Snellville, GA 30078-2130

Mailing address

1520 Scenic Hwy N
Snellville, GA 30078-2130
Phone (917) 517-9488

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080505000079 GA Part B Supplier - Clinic/Group Practice 7810076726 Receives reassigned benefits from 1 practitioner
Practice locations: Atlanta, GA; Snellville, GA

National Provider Directory

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, 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": "1177545600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1212451200000",
    "number": "1205056173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1520 SCENIC HWY N",
            "city": "SNELLVILLE",
            "state": "GA",
            "postal_code": "300782130",
            "telephone_number": "917-517-9488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1520 SCENIC HWY N",
            "city": "SNELLVILLE",
            "state": "GA",
            "postal_code": "300782130",
            "telephone_number": "770-979-2198"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PINNACLE EYECARE PROFESSIONALS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-26",
        "last_updated": "2008-06-03",
        "status": "A",
        "authorized_official_last_name": "KWONG",
        "authorized_official_first_name": "HERMAN",
        "authorized_official_middle_name": "ANTHONY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "770-979-2198",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152WC0802X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "GA",
            "license": "1934",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Snellville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2008; 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.