Individual provider Active NPI

Garland Keith Berry, M.D.

  • Ophthalmology Physician
  • Carrollton, GA
National Provider Identifier
1275597296
Registry record updated Dec 16, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
31419 Issued in TN
Practice address
158 Clinic Ave
Carrollton, GA 30117-4414
Phone
(770) 834-1008
Fax
(770) 834-2531
NPI assigned
Apr 14, 2006
Last updated
Dec 16, 2009By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 31419 TN Primary

Addresses

Primary practice location

158 Clinic Ave
Carrollton, GA 30117-4414

Mailing address

158 Clinic Ave
Carrollton, GA 30117-4414
Phone (770) 834-1008

Other identifiers 6

IdentifierTypeStateIssuer
766343094DMedicaidGA
766343094EMedicaidGA
766343094FMedicaidGA
766343094BMedicaidGA
766343094CMedicaidGA
766343094AMedicaidGA

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080722000117 GA Practitioner - Ophthalmology 6608949896 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Duke University School of Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Georgia Vision InstituteGroup PAC ID 4880962091, 8 clinicians

Practice addresses (Care Compare)

158 Clinic Ave
Suite a
Carrollton, GA 30117-4414
Phone (770) 834-1008

Merit-based Incentive Payment System (MIPS)

Final score
98.81 of 100Reported as group
Quality
97.63
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery553

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Georgia Vision Institute Ophthalmology CurrentSince Apr 24, 2017 Accepting new patients
Georgia Cataract and Eye Specialty Center LLC CurrentSince Oct 1, 2012 Accepting new patients

Locations

300 Alabama Ave S
Bremen, GA 30110
Phone (678) 821-1880

158 Clinic Ave
Carrollton, GA 30117
Phone (770) 834-1008

158 Clinic Ave
#B
Carrollton, GA 30117
Phone (770) 834-1001

158 Clinic Ave
Ste A
Carrollton, GA 30117
Phone (770) 834-1008

Organizations & group practices 2

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": "1144972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1260921600000",
    "number": "1275597296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "158 CLINIC AVE",
            "city": "CARROLLTON",
            "state": "GA",
            "postal_code": "301174414",
            "telephone_number": "770-834-1008",
            "fax_number": "770-834-2531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "158 CLINIC AVE",
            "city": "CARROLLTON",
            "state": "GA",
            "postal_code": "301174414",
            "telephone_number": "770-834-1008",
            "fax_number": "770-834-2531"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERRY",
        "first_name": "GARLAND",
        "middle_name": "KEITH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-14",
        "last_updated": "2009-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "TN",
            "license": "31419",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "766343094D",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "766343094E",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "766343094F",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "766343094B",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "766343094C",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "766343094A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Carrollton, GA

Sources for this page

Verify at the official NPI Registry.