Active NPI
Elton Jack Moomey, OD
- Optometrist
- Martinez, GA
National Provider Identifier
1275721409
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- OPT000709
- Practice address
- 127 S Belair Rd
Martinez, GA 30907-9111 - Phone
- (706) 869-1800
- Fax
- (706) 855-8159
- NPI assigned
- Oct 12, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | OPT000709 | GA | Primary |
Addresses
Primary practice location
127 S Belair Rd
Martinez, GA 30907-9111
Mailing address
127 S Belair Rd
Martinez, GA 30907-9111
Phone (706) 869-1800
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OPT000709 | GA | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1192147200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1192147200000",
"number": "1275721409",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "127 S BELAIR RD",
"city": "MARTINEZ",
"state": "GA",
"postal_code": "309079111",
"telephone_number": "706-869-1800",
"fax_number": "706-855-8159"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "127 S BELAIR RD",
"city": "MARTINEZ",
"state": "GA",
"postal_code": "309079111",
"telephone_number": "706-869-1800",
"fax_number": "706-855-8159"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOOMEY",
"first_name": "ELTON",
"middle_name": "JACK",
"name_prefix": "Dr.",
"credential": "OD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-10-12",
"last_updated": "2007-10-12",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "GA",
"license": "OPT000709",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Martinez, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.