Individual provider Active NPI

Marissa Thornton, OD

  • Optometrist
  • Smyrna, GA
National Provider Identifier
1245120575
Registry record updated Jul 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT003673 Issued in GA
Practice address
1655 Spring Rd SE
Smyrna, GA 30080-3774
Phone
(678) 842-9544
NPI assigned
Jul 8, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPT003673 GA Primary

Addresses

Primary practice location

1655 Spring Rd SE
Smyrna, GA 30080-3774

Mailing address

1655 Spring Rd SE
Smyrna, GA 30080-3774

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250722003728 GA Order and Referring Only - OptometryPractitioner - Optometry 5193231579

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1160 Johnson Ferry Rd
Unit 1157
Sandy Springs, GA 30342-2194

1655 Spring Rd SE
Smyrna, GA 30080-3774

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Stephen Rothbloom OD, LLC Optometrist CurrentSince Jul 13, 2025 Accepting new patients

Locations

1655 Spring Rd SE
Smyrna, GA 30080
Phone (678) 842-9544

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": "1751932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751932800000",
    "number": "1245120575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1655 SPRING RD SE",
            "city": "SMYRNA",
            "state": "GA",
            "postal_code": "300803774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1655 SPRING RD SE",
            "city": "SMYRNA",
            "state": "GA",
            "postal_code": "300803774",
            "telephone_number": "678-842-9544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THORNTON",
        "first_name": "MARISSA",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-07-08",
        "last_updated": "2025-07-08",
        "certification_date": "2025-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "GA",
            "license": "OPT003673",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Smyrna, GA

Sources for this page

Verify at the official NPI Registry.