Organization Active NPI

Leah Johnson McFerren, O.D., P.C.

  • Optometrist
  • College Park, GA
National Provider Identifier
1306250857
Registry record updated Aug 4, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT001216 Issued in GA
Legal business name
LEAH JOHNSON MCFERREN, O.D., P.C.
Practice address
1704 Virginia Ave
College Park, GA 30337-2014
Phone
(404) 768-3500
NPI assigned
Jun 12, 2014
Last updated
Aug 4, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2014

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

Authorized official

Name
Dr. Leah McFerren, O.D.NPI 1508943713
Title
President
Phone
(404) 768-3500

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 OPT001216 GA Primary

Addresses

Primary practice location

1704 Virginia Ave
College Park, GA 30337-2014

Mailing address

1704 Virginia Ave
College Park, GA 30337-2014
Phone (404) 768-3500

Other identifiers 1

IdentifierTypeStateIssuer
000687794AMedicaidGA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140630001380 GA Part B Supplier - Clinic/Group Practice 4587889803 Receives reassigned benefits from 1 practitioner
Practice locations: College Park, GA

National Provider Directory

National Provider Directory

Locations

1704 Virginia Ave
College Park, GA 30337
Phone (404) 768-3500

Practitioners & affiliated clinicians

Practitioners 1

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": "1402531200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1407110400000",
    "number": "1306250857",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1704 VIRGINIA AVE",
            "city": "COLLEGE PARK",
            "state": "GA",
            "postal_code": "303372014",
            "telephone_number": "404-768-3500",
            "fax_number": "404-768-9104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1704 VIRGINIA AVE",
            "city": "COLLEGE PARK",
            "state": "GA",
            "postal_code": "303372014",
            "telephone_number": "404-768-3500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEAH JOHNSON MCFERREN, O.D., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-12",
        "last_updated": "2014-08-04",
        "status": "A",
        "authorized_official_last_name": "MCFERREN",
        "authorized_official_first_name": "LEAH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "404-768-3500",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "GA",
            "license": "OPT001216",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000687794A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in College Park, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2014; 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.