Active NPI
Atlanta Eye International Surgery Center Inc.
- Ambulatory Surgical Clinic/Center
- Atlanta, GA
National Provider Identifier
1285655464
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ambulatory Surgical Clinic/Center
- License
- 11-C0001213
- Legal business name
- ATLANTA EYE INTERNATIONAL SURGERY CENTER INC.
- Practice address
- 830 W Peachtree St NW
Suite 101
Atlanta, GA 30308-1129 - Phone
- (404) 881-6417
- Fax
- (404) 876-7565
- NPI assigned
- Jul 22, 2006
- Last updated
- Jun 21, 2012
- Organization subpart
- Yes
- Parent organization
- ATLANTA EYE CONSULTANT
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Shelby Ray Wilkes, M.D.
- Title
- Medical Director
- Phone
- (404) 881-6417
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ambulatory Surgical Clinic/Center | 261QA1903X | 11-C0001213 | GA | Primary |
Addresses
Primary practice location
830 W Peachtree St NW
Suite 101
Atlanta, GA 30308-1129
Mailing address
830 W Peachtree St NW
Suite 101
Atlanta, GA 30308-1129
Phone (404) 881-6417
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
NPI to CCN mapping 1
The Medicare certification numbers (CCNs) connected to NPI 1285655464. Details of each certification follow.
Ambulatory surgical center certification: CCN 11C0001213
Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.
- Legal name
- ATLANTA EYE INTERNATIONAL SURGERY CENTER
- Certification status
- Active
- Provider type (POS)
- Ambulatory surgical center
- Participating since
- Oct 17, 2002
- Last certification
- Jul 11, 2017
- Ownership / control type
- Proprietary
- Facility address
- 830 West Peachtree Street, NW
Atlanta, GA 30308
National Provider Directory
National Provider Directory- Part of
- Atlanta Eye Consultants PC
Locations
830 W Peachtree St NW
Ste 100
Atlanta, GA 30308
Phone (404) 881-6417
830 W Peachtree St NW
Ste 101
Atlanta, GA 30308
Phone (404) 881-6417
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153526400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1340236800000",
"number": "1285655464",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "830 W PEACHTREE ST NW",
"address_2": "SUITE 101",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303081129",
"telephone_number": "404-881-6417",
"fax_number": "404-876-7565"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "830 W PEACHTREE ST NW",
"address_2": "SUITE 101",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303081129",
"telephone_number": "404-881-6417",
"fax_number": "404-876-7565"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ATLANTA EYE INTERNATIONAL SURGERY CENTER INC.",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "ATLANTA EYE CONSULTANT",
"enumeration_date": "2006-07-22",
"last_updated": "2012-06-21",
"status": "A",
"authorized_official_last_name": "WILKES",
"authorized_official_first_name": "SHELBY",
"authorized_official_middle_name": "RAY",
"authorized_official_title_or_position": "MEDICAL DIRECTOR",
"authorized_official_telephone_number": "404-881-6417",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "M.D."
},
"taxonomies": [
{
"code": "261QA1903X",
"taxonomy_group": "",
"desc": "Clinic/Center, Ambulatory Surgical",
"state": "GA",
"license": "11-C0001213",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Atlanta, GA
- Atlanta ENT Sinus & Allergy Associates PC
- Atlanta Eye Associates Group LLC
- Atlanta Eye Care (Cumberland Pointe Eye Care)
- Atlanta Eye Center, LLC
- Atlanta Eye Consultants
- Atlanta Eye Shop, Inc
- Atlanta Family Foot Care, LLC
- Atlanta Family Home Care LLC
- Atlanta Family Medicine & Med Spa LLC
- Atlanta Family Neurology, PC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.