Individual provider Active NPI

Roselyn Thomas

  • Student in an Organized Health Care Education/Training Program
  • Douglasville, GA
National Provider Identifier
1346086113
Registry record updated Jul 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
1270 Arbor Place Mall
Douglasville, GA 30135-7105
Phone
(770) 942-9827
NPI assigned
Jul 2, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

1270 Arbor Place Mall
Douglasville, GA 30135-7105

Mailing address

3480 Lakeside Dr NE
Atlanta, GA 30326-1932
Phone (872) 222-0675

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
I20240814003701 GA Practitioner - Optometry 7315485968 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Infocus Eye Care, IncGroup PAC ID 0345594362, 5 clinicians

Practice addresses (Care Compare)

1270 Arbor Place Mall
Douglasville, GA 30135-7105
Phone (770) 942-9827

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Infocus Eye Care, Inc. CurrentSince Aug 5, 2024 Accepting new patients

Locations

6700 Douglas Blvd
Ste 1270
Douglasville, GA 30135
Phone (770) 577-4434

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1719878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719878400000",
    "number": "1346086113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3480 LAKESIDE DR NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303261932",
            "telephone_number": "872-222-0675"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1270 ARBOR PLACE MALL",
            "city": "DOUGLASVILLE",
            "state": "GA",
            "postal_code": "301357105",
            "telephone_number": "770-942-9827"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "ROSELYN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-02",
        "last_updated": "2024-07-02",
        "certification_date": "2024-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Douglasville, GA

Sources for this page

Verify at the official NPI Registry.