Atlanta Eye Associates

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPT002319 Issued in GA

Legal business name

ATLANTA EYE ASSOCIATES

Practice address

5456 Jimmy Carter Blvd Ste 180
Norcross, GA 30093-1545

Phone

(404) 355-2600

NPI assigned

Jul 18, 2013

Last updated

Jul 18, 2013By 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 Raharja, ODNPI 1720094527

Title

Ceo

Phone

(404) 355-2600

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Locations

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.

• Kim Chau Raharja, O.D.

  • Optometrist
  • Chamblee, GA
  • NPI 1720094527
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1374105600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1374105600000",
    "number": "1255773347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5456 JIMMY CARTER BLVD STE 180",
            "city": "NORCROSS",
            "state": "GA",
            "postal_code": "300931545",
            "telephone_number": "404-355-2600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5456 JIMMY CARTER BLVD STE 180",
            "city": "NORCROSS",
            "state": "GA",
            "postal_code": "300931545",
            "telephone_number": "404-355-2600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ATLANTA EYE ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-07-18",
        "last_updated": "2013-07-18",
        "status": "A",
        "authorized_official_last_name": "RAHARJA",
        "authorized_official_first_name": "KIM",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "404-355-2600",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "GA",
            "license": "OPT002319",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• No Name Given Ashwani
• Associated Provider Services
• Briana Monique Astorga
• Atlanta Cardiac & Vascular Specialist
• Atlanta Caregivers and Associates LLC
• Atlanta Family Palliative Care LLC
• Atlanta General Education Center (Loving Hands Private Care)
• Atlanta Hospice,LLC
• Atlanta International PT, Inc
• Atlanta Joint Specialist LLC

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2013; 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.