Peachtree Ophthalmology LLC

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

Legal business name

PEACHTREE OPHTHALMOLOGY LLC

Practice address

4045 Wetherburn Way Ste 1
Norcross, GA 30092-4611

Phone

(770) 285-7910

NPI assigned

Jun 6, 2023

Organization subpart

No

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

Authorized official

Name

Edward T Washington Jr., MDNPI 1104211283

Title

Owner

Phone

(770) 285-7910

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Edward Theodore Washington Jr.

  • Glaucoma Specialist (Ophthalmology) Physician
  • Norcross, GA
  • NPI 1104211283
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1686009600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1693353600000",
    "number": "1285328849",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4045 WETHERBURN WAY STE 1",
            "city": "NORCROSS",
            "state": "GA",
            "postal_code": "300924611",
            "telephone_number": "770-285-7910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4045 WETHERBURN WAY STE 1",
            "city": "NORCROSS",
            "state": "GA",
            "postal_code": "300924611",
            "telephone_number": "770-285-7910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEACHTREE OPHTHALMOLOGY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-06-06",
        "last_updated": "2023-08-30",
        "certification_date": "2023-08-30",
        "status": "A",
        "authorized_official_last_name": "WASHINGTON",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "770-285-7910",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• PCH Services Inc
• Pcti
• Peachtree Corners Chiropractic Clinic
• Peachtree Corners Eye Clinic
• Peachtree Diagnostic Laboratories Inc
• Peachtree Rapidcare Medical Center Inc
• Peachtree Recovery Solutions
• Peachtree Surgical Associates
• Peachtree Surgical Associates
• Alyse Pearson-Bryant

• Ophthalmology Physician in Norcross, GA
• Providers in Norcross, GA by specialty
• Ophthalmology Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2023; 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.