Individual provider Active NPI

John David Miller, O.D.

  • Optometrist
  • Marietta, GA
National Provider Identifier
1275685554
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT000863 Issued in GA
Practice address
4343 Shallowford Rd
Suite F-1
Marietta, GA 30062-5023
Phone
(770) 640-7800
Fax
(770) 640-7779
NPI assigned
Jan 17, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPT000863 GA Primary

Addresses

Primary practice location

4343 Shallowford Rd
Suite F-1
Marietta, GA 30062-5023

Mailing address

4343 Shallowford Rd
Suite F-1
Marietta, GA 30062-5023
Phone (770) 640-7800

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
I20120222000265 GA Practitioner - Optometry 5193983179 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Thomas Eye Group PCGroup PAC ID 2567455868, 51 clinicians

Practice addresses (Care Compare)

11690 Alpharetta Hwy
Roswell, GA 30076-3805
Phone (770) 475-5515

3960 Shallowford Rd
Suite a
Marietta, GA 30062-5058
Phone (770) 642-4001

Merit-based Incentive Payment System (MIPS)

Final score
94.51 of 100Reported as apm
Quality
80.61
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
000863GAMDFoot & Ankle Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Thomas Eye Group PC Optometrist CurrentSince Jan 1, 2021 Accepting new patients
Thomas Eye Group PC CurrentSince Jan 1, 2021 Accepting new patients
Thomas Eye Group PC Optometrist Current Accepting new patients

Locations

3960 Shallowford Rd
Ste A
Marietta, GA 30062
Phone (770) 642-4001

11690 Alpharetta Hwy
Roswell, GA 30076
Phone (770) 475-5515

5995 Barfield Rd
Sandy Springs, GA 30328
Phone (404) 256-1507

Interoperability endpoints

  • Direct secure messaging: jmiller@teg.emadirect.md

Organizations & group practices 4

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": "1168992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1275685554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4343 SHALLOWFORD RD",
            "address_2": "SUITE F-1",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300625023",
            "telephone_number": "770-640-7800",
            "fax_number": "770-640-7779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4343 SHALLOWFORD RD",
            "address_2": "SUITE F-1",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300625023",
            "telephone_number": "770-640-7800",
            "fax_number": "770-640-7779"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "JOHN",
        "middle_name": "DAVID",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "GA",
            "license": "OPT000863",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marietta, GA

Sources for this page

Verify at the official NPI Registry.