Dennis Lee Cowart, OD
Individual provider Active NPI Optometrist · Bremen, GA
NPI 1376737486 · NPPES record last updated Jul 14, 2021
Key facts
- NPI
- 1376737486
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Optometrist 152W00000X
- License
- OPT000902 (GA)
- Practice address
- 207 Chestnut St
Bremen, GA 30110-2021 - Phone
- (770) 537-5246
- Fax
- (770) 537-1313
- NPI assigned
- Aug 31, 2007
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 12
Medicare Care Compare profile
- Specialty
- Optometry
- Education
- University Alabama Birmingham - School of Optometry, 2000
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Myeyedr Optometry of Georgia, LLC
Practice addresses (Care Compare)
123 W Main St
A
Cartersville, GA 30120-3507
Phone (470) 888-2044
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Cataract surgery | 35 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in GA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20070905000165 | GA | Practitioner - Optometry | 0345333571 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OPT000902 | GA | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Myeyedr Optometry of Georgia, LLC | Optometrist | Current | Accepting new patients |
| Optix Laser & Eye Center LLC | Optometrist | Current |
Accepting new patients |
| Myeyedr Optometry of Georgia, LLC | Optometrist | Current |
Accepting new patients |
| Myeyedr Optometry of Georgia, LLC | Optometrist | Current |
Accepting new patients |
| Myeyedr Optometry of Georgia, LLC | Optometrist | Past | Accepting new patients |
Locations
6121 Cedarcrest Rd NW
#108
Acworth, GA 30101
Phone (770) 529-7789
207 Chestnut St
Bremen, GA 30110
Phone (770) 537-5246
4875 Altama Ave
Brunswick, GA 31520
Phone (912) 554-0010
123 W Main St
#A
Cartersville, GA 30120
Phone (470) 888-2044
8614 Westwood Center Dr
Fl 9
Vienna, VA 22182
1950 Old Gallows Rd
Ste 520
Vienna, VA 22182
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | OPT000902 | GA | Yes |
Addresses
Primary practice location
207 Chestnut St
Bremen, GA 30110-2021
Mailing address
1950 Old Gallows Rd Ste 520
Vienna, VA 22182-3970
Phone (703) 847-8899
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 009915685 | Other | GA | ALABAMA MEDICAID |
| 000204256A | Medicaid | GA |
NPI Registry JSON
{
"created_epoch": "1188518400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1626220800000",
"number": "1376737486",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1950 OLD GALLOWS RD STE 520",
"city": "VIENNA",
"state": "VA",
"postal_code": "221823970",
"telephone_number": "703-847-8899",
"fax_number": "571-223-6780"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "207 CHESTNUT ST",
"city": "BREMEN",
"state": "GA",
"postal_code": "301102021",
"telephone_number": "770-537-5246",
"fax_number": "770-537-1313"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COWART",
"first_name": "DENNIS",
"middle_name": "LEE",
"credential": "OD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-08-31",
"last_updated": "2021-07-14",
"certification_date": "2021-07-14",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "GA",
"license": "OPT000902",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ALABAMA MEDICAID",
"identifier": "009915685",
"state": "GA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "000204256A",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Bremen, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 14, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.