NPIMap

Organization Active NPI

Jose Goncalves, OD

  • Optometrist
  • Marietta, GA
National Provider Identifier
1396913711
Registry record updated Feb 19, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT002068 Issued in GA
Legal business name
JOSE GONCALVES, OD
Practice address
1401 Johnson Ferry Rd
Ste 148 B
Marietta, GA 30062-6495
Phone
(770) 509-8480
Fax
(770) 509-0725
NPI assigned
Feb 19, 2008
Last updated
Feb 19, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2008

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

Authorized official

Name
Jose Goncalves, ODNPI 1578681441
Title
Owner
Phone
(770) 509-8480

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X OPT002068 GA Primary

Addresses

Primary practice location

1401 Johnson Ferry Rd
Ste 148 B
Marietta, GA 30062-6495

Mailing address

1401 Johnson Ferry Rd
Ste 148 B
Marietta, GA 30062-6495
Phone (770) 509-8480

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1203379200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1203379200000",
    "number": "1396913711",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 JOHNSON FERRY RD",
            "address_2": "STE 148 B",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300626495",
            "telephone_number": "770-509-8480",
            "fax_number": "770-509-0725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 JOHNSON FERRY RD",
            "address_2": "STE 148 B",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300626495",
            "telephone_number": "770-509-8480",
            "fax_number": "770-509-0725"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOSE GONCALVES, OD",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-19",
        "last_updated": "2008-02-19",
        "status": "A",
        "authorized_official_last_name": "GONCALVES",
        "authorized_official_first_name": "JOSE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "770-509-8480",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "GA",
            "license": "OPT002068",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marietta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2008; 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.