Individual provider Active NPI

Robert Baldwin, O.D.

  • Optometrist
  • Snellville, GA
National Provider Identifier
1265710529
Registry record updated Aug 2, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT002656 Issued in GA
Practice address
2427 Heritage VLG Ste 4
Snellville, GA 30078-2699
Phone
(770) 978-2020
Fax
(770) 978-1750
NPI assigned
Aug 3, 2011
Last updated
Aug 2, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPT002656 GA Primary

Addresses

Primary practice location

2427 Heritage VLG Ste 4
Snellville, GA 30078-2699

Mailing address

1862 Jonesboro Rd
McDonough, GA 30253-5960

Other practice location 1

1862 Jonesboro Rd
McDonough, GA 30253-5960
Phone (678) 432-1584

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
I20110831000597 GA Practitioner - Optometry 7719157650 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Clarkson Optometry Georgia Inc Optometrist CurrentSince May 1, 2018 Accepting new patients
Oconee Vision Group, LLC Optometrist CurrentSince Sep 10, 2018 Accepting new patients
My Saviours Grace LLC Optometrist Past Accepting new patients
Bruce L Hammonds OD PC Optometrist PastSince Sep 10, 2018 Accepting new patients
Clarkson Optometry Georgia Inc Optometrist Past Accepting new patients

Locations

8400 Holcomb Bridge Rd
Ste 440
Alpharetta, GA 30022
Phone (770) 645-1222

2427 Heritage Vlg
Ste 4
Snellville, GA 30078
Phone (770) 978-2020

2281 Hog Mountain Rd
Ste C
Watkinsville, GA 30677
Phone (706) 769-4404

Interoperability endpoints

  • FHIR API: https://app.meldrx.com/api/fhir/ecp_cecga

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1312329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1533168000000",
    "number": "1265710529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1862 JONESBORO RD",
            "city": "MCDONOUGH",
            "state": "GA",
            "postal_code": "302535960"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2427 HERITAGE VLG STE 4",
            "city": "SNELLVILLE",
            "state": "GA",
            "postal_code": "300782699",
            "telephone_number": "770-978-2020",
            "fax_number": "770-978-1750"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1862 Jonesboro Rd",
            "address_purpose": "LOCATION",
            "city": "McDonough",
            "state": "GA",
            "postal_code": "302535960",
            "country_code": "US",
            "telephone_number": "678-432-1584",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BALDWIN",
        "first_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-08-03",
        "last_updated": "2018-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "GA",
            "license": "OPT002656",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Snellville, GA

Sources for this page

Verify at the official NPI Registry.