Mobley Riverdale Eye Clinic Inc

Primary specialty

OptometristTaxonomy code 152W00000X

License

912T Issued in GA

Legal business name

MOBLEY RIVERDALE EYE CLINIC INC

Practice address

539 Glynn St N
Suite a
Fayetteville, GA 30214-1108

Phone

(678) 817-7722

Fax

(678) 817-0067

NPI assigned

Mar 17, 2008

Organization subpart

No

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

Authorized official

Name

B. Dean Mobley, OD

Title

Owner / OD

Phone

(678) 817-7722

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 8

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

• Janelle Lynette Davison, O.D.

  • Optometrist
  • Smyrna, GA
  • NPI 1053475855
  NPD (past)
• Jacob Daniel Deweese, OD

  • Optometrist
  • Marietta, GA
  • NPI 1699437129
  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)
• Katelyn Wilma Lohman, O.D.

  • Optometrist
  • Canton, GA
  • NPI 1548619315
  NPD (past)
• Robert Mobley, OD

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

  • Optometrist
  • Atlanta, GA
  • NPI 1871117879
  NPD (past)
• Kellie Stewart, O.D.

  • Optometrist
  • Atlanta, GA
  • NPI 1972896967
  NPD (past)

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

{
    "created_epoch": "1205712000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1315785600000",
    "number": "1407027683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "539 GLYNN ST N",
            "address_2": "SUITE A",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302141108",
            "telephone_number": "678-817-7722",
            "fax_number": "678-817-0067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "539 GLYNN ST N",
            "address_2": "SUITE A",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302141108",
            "telephone_number": "678-817-7722",
            "fax_number": "678-817-0067"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOBLEY RIVERDALE EYE CLINIC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-17",
        "last_updated": "2011-09-12",
        "status": "A",
        "authorized_official_last_name": "MOBLEY",
        "authorized_official_first_name": "B. DEAN",
        "authorized_official_title_or_position": "OWNER / OD",
        "authorized_official_telephone_number": "678-817-7722",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "GA",
            "license": "912T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00214629C",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Stacey Lasandra Mitchell, NP
• Steven Allgood Mitchell, DDS
• Terria Mitchell
• Tiara Mitchell, RBT
• Prabhakar Mithal
• Christen Machela Mobley
• Velma Mobley
• Dhruv Kamleshkumar Modi, MD
• Bethseba Mogaka, RBT
• Carmen Patrick Mohan, MD

• 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 Sep 12, 2011; 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.