Individual provider Active NPI

Gregory W Payne, O.D.

  • Optometrist
  • Suwanee, GA
National Provider Identifier
1306952965
Registry record updated Aug 26, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
001220 Issued in GA
Practice address
4330 Johns Creek Pkwy
Suite 300
Suwanee, GA 30024-6047
Phone
(770) 232-7844
Fax
(770) 232-9455
NPI assigned
Aug 23, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 001220 GA Primary

Addresses

Primary practice location

4330 Johns Creek Pkwy
Suite 300
Suwanee, GA 30024-6047

Mailing address

4330 Johns Creek Pkwy
Suite 300
Suwanee, GA 30024-6047
Phone (770) 232-7844

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120308000198 GA Practitioner - Optometry 6002717055 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Payne and Payne PCGroup PAC ID 5597666545, 5 clinicians

Practice addresses (Care Compare)

4330 Johns Creek Pkwy
Suite 300
Suwanee, GA 30024-6121
Phone (770) 232-7844

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
001220GAMDFamily Medicine Physician
1220GAMDPhysical Therapy Clinic/Center

Practice roles

OrganizationSpecialtyStatusNew patients
Payne & Payne, PC Optometrist CurrentSince Feb 21, 2012 Accepting new patients
Oneopto Ga 1 PLLC Optometrist PastSince Feb 21, 2012 Accepting new patients

Locations

9995 Jones Bridge Rd
Johns Creek, GA 30022
Phone (678) 366-1200

9995 Jones Bridge Rd
#200
Johns Creek, GA 30022
Phone (770) 475-1242

4330 Johns Creek Pkwy
Ste 300
Suwanee, GA 30024
Phone (770) 232-7844

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1156291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1282780800000",
    "number": "1306952965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4330 JOHNS CREEK PKWY",
            "address_2": "SUITE 300",
            "city": "SUWANEE",
            "state": "GA",
            "postal_code": "300246047",
            "telephone_number": "770-232-7844",
            "fax_number": "770-232-9455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4330 JOHNS CREEK PKWY",
            "address_2": "SUITE 300",
            "city": "SUWANEE",
            "state": "GA",
            "postal_code": "300246047",
            "telephone_number": "770-232-7844",
            "fax_number": "770-232-9455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAYNE",
        "first_name": "GREGORY",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-23",
        "last_updated": "2010-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "GA",
            "license": "001220",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Suwanee, GA

Sources for this page

Verify at the official NPI Registry.