Organization Active NPI

John B. Whitlow, O.D.P.C.

  • Optometrist
  • Lagrange, GA
National Provider Identifier
1285843524
Registry record updated May 19, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT001301 Issued in GA
Legal business name
JOHN B. WHITLOW, O.D.P.C.
Practice address
407 S Greenwood St
Lagrange, GA 30240-3123
Phone
(706) 882-0616
Fax
(706) 882-8515
NPI assigned
May 22, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 19, 2011

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

Authorized official

Name
Dr. Donna Gaskins Whitlow, O.D.NPI 1528053618
Title
Secretary
Phone
(706) 882-0616

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
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X OPT001301 GA Primary

Addresses

Primary practice location

407 S Greenwood St
Lagrange, GA 30240-3123

Mailing address

407 S Greenwood St
Lagrange, GA 30240-3123
Phone (706) 882-0616

Other names 1

  • West Georgia Vision Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040511000055 GA Part B Supplier - Clinic/Group Practice 7012906480 Receives reassigned benefits from 2 practitioners
Practice locations: Lagrange, GA

National Provider Directory

National Provider Directory

Locations

407 S Greenwood St
Lagrange, GA 30240
Phone (706) 882-0616

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1179792000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1305763200000",
    "number": "1285843524",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "407 S GREENWOOD ST",
            "city": "LAGRANGE",
            "state": "GA",
            "postal_code": "302403123",
            "telephone_number": "706-882-0616",
            "fax_number": "706-882-8515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "407 S GREENWOOD ST",
            "city": "LAGRANGE",
            "state": "GA",
            "postal_code": "302403123",
            "telephone_number": "706-882-0616",
            "fax_number": "706-882-8515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHN B. WHITLOW, O.D.P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-22",
        "last_updated": "2011-05-19",
        "status": "A",
        "authorized_official_last_name": "WHITLOW",
        "authorized_official_first_name": "DONNA",
        "authorized_official_middle_name": "GASKINS",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "706-882-0616",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "GA",
            "license": "OPT001301",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "West Georgia Vision Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lagrange, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2011; 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.