Timothy Alan Parker OD LLC

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

TIMOTHY ALAN PARKER OD LLC

Practice address

88 Highland Xing
Ellijay, GA 30540-6052

Phone

(706) 635-1194

Fax

(706) 515-2021

NPI assigned

Jan 16, 2023

Organization subpart

No

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

Authorized official

Name

Timothy ParkerNPI 1972541738

Title

OD

Phone

(813) 995-7577

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.

• Timothy Alan Parker, O.D.

  • Optometrist
  • Cornelia, GA
  • NPI 1972541738
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1673827200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1675641600000",
    "number": "1326753294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "956 MINING GAP LN",
            "city": "YOUNG HARRIS",
            "state": "GA",
            "postal_code": "305822324",
            "telephone_number": "813-995-7577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "88 HIGHLAND XING",
            "city": "ELLIJAY",
            "state": "GA",
            "postal_code": "305406052",
            "telephone_number": "706-635-1194",
            "fax_number": "706-515-2021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TIMOTHY ALAN PARKER OD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-01-16",
        "last_updated": "2023-02-06",
        "certification_date": "2023-02-06",
        "status": "A",
        "authorized_official_last_name": "PARKER",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_title_or_position": "OD",
        "authorized_official_telephone_number": "813-995-7577"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Optometrist in Ellijay, GA
• Providers in Ellijay, GA by specialty
• Optometrist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 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.