Individual provider Active NPI

Pamela Denise Earls, OD

  • Optometrist
  • Macon, GA
National Provider Identifier
1396229340
Registry record updated Sep 15, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
001489 Issued in GA
Practice address
101 Westchester Dr
Macon, GA 31210-7536
Phone
(478) 474-4024
NPI assigned
Sep 15, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 15, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 001489 GA Primary

Addresses

Primary practice location

101 Westchester Dr
Macon, GA 31210-7536

Mailing address

101 Westchester Dr
Macon, GA 31210-7536
Phone (478) 474-4024

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
I20190327002745 GA Practitioner - Optometry 6406196567 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pennsylvania College of Optometry, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Depoe Eye Center PCGroup PAC ID 8224927702, 14 clinicians

Practice addresses (Care Compare)

5451 Bowman Rd
Suite 420
Macon, GA 31210-5783
Phone (478) 741-3960

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
001489GAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Depoe Eye Center PC Optometrist CurrentSince Jan 16, 2019 Accepting new patients

Locations

681 S 8th St
Griffin, GA 30224
Phone (770) 228-2020

300 N Main St
Ste 301
Jonesboro, GA 30236
Phone (770) 603-0063

5451 Bowman Rd
Macon, GA 31210
Phone (478) 474-3064

5451 Bowman Rd
Ste 420
Macon, GA 31210
Phone (478) 741-3960

550 Eagles Landing Pkwy
Ste 208
Stockbridge, GA 30281
Phone (770) 415-8982

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": "1536969600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536969600000",
    "number": "1396229340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 WESTCHESTER DR",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312107536",
            "telephone_number": "478-474-4024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 WESTCHESTER DR",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312107536",
            "telephone_number": "478-474-4024"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EARLS",
        "first_name": "PAMELA",
        "middle_name": "DENISE",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-09-15",
        "last_updated": "2018-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "GA",
            "license": "001489",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Macon, GA

Sources for this page

Verify at the official NPI Registry.