Organization Active NPI

MC DO Optometry LLC

  • Optometrist
  • Calhoun, GA
National Provider Identifier
1396388542
Registry record updated Dec 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
MC DO OPTOMETRY LLC
Doing business as
Walmart Health
Practice address
448 West Belmont Drive
Calhoun, GA 30701-3016
Phone
(762) 204-6428
Fax
(706) 692-8121
NPI assigned
Oct 21, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2021

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

Authorized official

Name
Michael DO
Title
President
Phone
(762) 204-6428

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X Primary

Addresses

Primary practice location

448 West Belmont Drive
Calhoun, GA 30701-3016

Mailing address

702 SW 8TH St
Bentonville, AR 72716-6209
Phone (479) 204-1258

Other practice location 1

101 Market Place Blvd Ste B
Cartersville, GA 30121-2236
Phone (470) 490-8172

Other names 1

  • Walmart Health Doing business as

National Provider Directory

National Provider Directory

Locations

101 Market Place Blvd
Ste B
Cartersville, GA 30121
Phone (470) 490-8170

137 Willow LN
McDonough, GA 30253
Phone (470) 483-0409

2042 W Spring St
Monroe, GA 30655
Phone (770) 266-5746

6435 Bells Ferry Rd
Ste 110
Woodstock, GA 30189
Phone (770) 928-0574

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1571616000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1638835200000",
    "number": "1396388542",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "702 SW 8TH ST",
            "city": "BENTONVILLE",
            "state": "AR",
            "postal_code": "727166209",
            "telephone_number": "479-204-1258"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "448 WEST BELMONT DRIVE",
            "city": "CALHOUN",
            "state": "GA",
            "postal_code": "307013016",
            "telephone_number": "762-204-6428",
            "fax_number": "706-692-8121"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "101 Market Place Blvd Ste B",
            "address_purpose": "LOCATION",
            "city": "Cartersville",
            "state": "GA",
            "postal_code": "301212236",
            "country_code": "US",
            "telephone_number": "470-490-8172",
            "fax_number": "770-607-5181",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MC DO OPTOMETRY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-21",
        "last_updated": "2021-12-07",
        "certification_date": "2021-12-07",
        "status": "A",
        "authorized_official_last_name": "DO",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "762-204-6428"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Walmart Health",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Walmart Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Calhoun, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.