Active NPI
Melvin R. Weiss, O.D.
- Optometrist
- Smyrna, GA
National Provider Identifier
1205838554
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 740
- Practice address
- 1239 Concord Rd SE
Smyrna, GA 30080-4310 - Phone
- (770) 435-4457
- Fax
- (770) 435-4555
- NPI assigned
- Jun 1, 2005
- Last updated
- Jan 3, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 740 | GA | Primary |
Addresses
Primary practice location
1239 Concord Rd SE
Smyrna, GA 30080-4310
Mailing address
1239 Concord Rd SE
Smyrna, GA 30080-4310
Phone (770) 435-4457
Other identifiers 7
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 11461 | Other | GA | OPTICARE |
| 727825 | Other | GA | BCBS |
| 1066147 | Other | GA | AMERIGROUP |
| 331302 | Other | GA | CIGNA |
| 4239284 | Other | GA | AETNA |
| 00004925B | Medicaid | GA | |
| 2230037 | Other | GA | UNITED HEALTHCARE |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 740 | GA | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1117584000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1199318400000",
"number": "1205838554",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1239 CONCORD RD SE",
"city": "SMYRNA",
"state": "GA",
"postal_code": "300804310",
"telephone_number": "770-435-4457",
"fax_number": "770-435-4555"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1239 CONCORD RD SE",
"city": "SMYRNA",
"state": "GA",
"postal_code": "300804310",
"telephone_number": "770-435-4457",
"fax_number": "770-435-4555"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WEISS",
"first_name": "MELVIN",
"middle_name": "R.",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-06-01",
"last_updated": "2008-01-03",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "GA",
"license": "740",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OPTICARE",
"identifier": "11461",
"state": "GA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "727825",
"state": "GA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AMERIGROUP",
"identifier": "1066147",
"state": "GA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "331302",
"state": "GA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "4239284",
"state": "GA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00004925B",
"state": "GA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HEALTHCARE",
"identifier": "2230037",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Smyrna, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.