TJ Roberts, LLC

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

TJ ROBERTS, LLC

Practice address

539 Glynn St N
Fayetteville, GA 30214-1108

Phone

(678) 817-7722

Fax

(678) 817-0067

NPI assigned

May 17, 2019

Organization subpart

No

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

Authorized official

Name

Dr. Terrence Roberts, ODNPI 1194157289

Title

Owner

Phone

(770) 256-6073

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Every Eye Care Doing business as

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Terrence Jawaan Roberts, O.D.

  • Optometrist
  • Fayetteville, GA
  • NPI 1194157289
  Medicare reassignment NPD Authorized official
• Janelle Lynette Davison, O.D.

  • Optometrist
  • Smyrna, GA
  • NPI 1053475855
  NPD (past)
• Marc Sacha Helmy, O.D.

  • Optometrist
  • Canton, GA
  • NPI 1013172238
  NPD (past)
• Brie Hevesy, O.D.

  • Optometrist
  • Acworth, GA
  • NPI 1497981898
  NPD (past)
• Bennie Dean Mobley, O.D.

  • Optometrist
  • Sharpsburg, GA
  • NPI 1215926233
  NPD (past)
• Robert Mobley, OD

  • Optometrist
  • Acworth, GA
  • NPI 1609801323
  NPD (past)

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

{
    "created_epoch": "1558051200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1558051200000",
    "number": "1386200046",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "524 MONARCH LAKE WAY",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "302817795",
            "telephone_number": "770-256-6073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "539 GLYNN ST N",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302141108",
            "telephone_number": "678-817-7722",
            "fax_number": "678-817-0067"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TJ ROBERTS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-05-17",
        "last_updated": "2019-05-17",
        "status": "A",
        "authorized_official_last_name": "ROBERTS",
        "authorized_official_first_name": "TERRENCE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "770-256-6073",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003208256A",
            "state": "GA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "eycarefayette@yahoo.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "539 Glynn St N",
            "city": "Fayetteville",
            "state": "GA",
            "country_code": "US",
            "postal_code": "302141108",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Every Eye Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2019; 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.