Atlanta Eye Center, LLC

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPT2319 Issued in GA

Legal business name

ATLANTA EYE CENTER, LLC

Practice address

1801 Howell Mill Rd
Wal-Mart Vision Center #3775
Atlanta, GA 30318

Phone

(404) 352-3414

Fax

(404) 352-3416

NPI assigned

Sep 7, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Kim C Raharja, OD

Title

Ceo

Phone

(678) 656-6305

Specialties & licenses 1

Addresses

Locations

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.

• Jamilah L Birdsong, O.D.

  • Optometrist
  • Decatur, GA
  • NPI 1598996431
  NPD (past)
• Stephen Mammoottil John, O.D.

  • Optometrist
  • Marietta, GA
  • NPI 1275763062
  NPD (past)
• Cara Patterson Robison, O.D.

  • Optometrist
  • Marietta, GA
  • NPI 1972750842
  NPD (past)
• Anh My Phung, O.D.

  • Optometrist
  • Tampa, FL
  • NPI 1407130644
  NPD (past)
• Omar Rivera Mojica, O.D.

  • Optometrist
  • Yabucoa, PR
  • NPI 1639339427
  NPD (past)

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

{
    "created_epoch": "1157587200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1205930666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4717 CAMBRIDGE TRCE",
            "city": "DUNWOODY",
            "state": "GA",
            "postal_code": "303385252",
            "telephone_number": "678-656-6305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 HOWELL MILL RD",
            "address_2": "WAL-MART VISION CENTER #3775",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "30318",
            "telephone_number": "404-352-3414",
            "fax_number": "404-352-3416"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ATLANTA EYE CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-07",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "RAHARJA",
        "authorized_official_first_name": "KIM",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "678-656-6305",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "GA",
            "license": "OPT2319",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Atlanta Emergency Services LLC
• Atlanta Energy Medicine Practice Incorporated
• Atlanta ENT Sinus & Allergy Associates PC
• Atlanta Eye Associates Group LLC
• Atlanta Eye Care (Cumberland Pointe Eye Care)
• Atlanta Eye Consultants
• Atlanta Eye International Surgery Center Inc.
• Atlanta Eye Shop, Inc
• Atlanta Family Foot Care, LLC
• Atlanta Family Home Care LLC

• Optometrist in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Optometrist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.