Organization Active NPI

Navid Reza Khoshooee OD LLC

  • Optometrist
  • Warner Robins, GA
National Provider Identifier
1285015784
Registry record updated Jun 11, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT002845 Issued in GA
Legal business name
NAVID REZA KHOSHOOEE OD LLC
Practice address
1112 Russell Pkwy
Warner Robins, GA 31088-1816
Phone
(407) 749-8670
NPI assigned
Jun 11, 2015
Last updated
Jun 11, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2015

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

Authorized official

Name
Dr. Navid Reza Khoshooee, O.D.NPI 1689079451
Title
Optometric Physician
Phone
(407) 749-8670

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPT002845 GA Primary

Addresses

Primary practice location

1112 Russell Pkwy
Warner Robins, GA 31088-1816

Mailing address

1112 Russell Pkwy
Warner Robins, GA 31088-1816
Phone (407) 749-8670

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170519001441 GA Part B Supplier - Clinic/Group Practice 9335416411 Receives reassigned benefits from 3 practitioners
Practice locations: Warner Robins, GA

National Provider Directory

National Provider Directory

Locations

2592 N Columbia St
Milledgeville, GA 31061
Phone (478) 452-2611

Practitioners & affiliated clinicians

Practitioners 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1433980800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1433980800000",
    "number": "1285015784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1112 RUSSELL PKWY",
            "city": "WARNER ROBINS",
            "state": "GA",
            "postal_code": "310881816",
            "telephone_number": "407-749-8670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1112 RUSSELL PKWY",
            "city": "WARNER ROBINS",
            "state": "GA",
            "postal_code": "310881816",
            "telephone_number": "407-749-8670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NAVID REZA KHOSHOOEE OD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-11",
        "last_updated": "2015-06-11",
        "status": "A",
        "authorized_official_last_name": "KHOSHOOEE",
        "authorized_official_first_name": "NAVID",
        "authorized_official_middle_name": "REZA",
        "authorized_official_title_or_position": "OPTOMETRIC PHYSICIAN",
        "authorized_official_telephone_number": "407-749-8670",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "GA",
            "license": "OPT002845",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Warner Robins, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2015; 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.