Organization Active NPI

Eyecontact Inc.

  • Optometrist
  • Acworth, GA
National Provider Identifier
1407054232
Registry record updated Jan 15, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2200 Issued in GA
Legal business name
EYECONTACT INC.
Practice address
1720 Mars Hill Rd NW Ste 160
Acworth, GA 30101-8089
Phone
(770) 529-1925
Fax
(770) 529-1982
NPI assigned
Jul 3, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2019

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

Authorized official

Name
Robert Wesley Mobley, O.D.NPI 1609801323
Title
President
Phone
(770) 529-1925

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 2200 GA Primary

Addresses

Primary practice location

1720 Mars Hill Rd NW Ste 160
Acworth, GA 30101-8089

Mailing address

1720 Mars Hill Rd NW Ste 160
Acworth, GA 30101-8089
Phone (770) 529-1925

Other identifiers 1

IdentifierTypeStateIssuer
763412534AMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070915000233 GA Part B Supplier - Clinic/Group Practice 2264526649 Receives reassigned benefits from 6 practitioners
Practice locations: Metter, GA; Vidalia, GA; Suwanee, GA; Lyons, GA; Dahlonega, GA; Acworth, GA; Baxley, GA; Elberton, GA…

National Provider Directory

National Provider Directory

Locations

1720 Mars Hill Rd NW
Ste 160
Acworth, GA 30101
Phone (770) 529-1925

3450 Cobb Pkwy NW
Ste 250
Acworth, GA 30101
Phone (770) 529-1925

1364 Telfair St
Dublin, GA 31021
Phone (478) 272-1133

307 Jones Mill Rd
Statesboro, GA 30458
Phone (912) 764-9011

Practitioners & affiliated clinicians

Practitioners 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1183420800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1547510400000",
    "number": "1407054232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1720 MARS HILL RD NW STE 160",
            "city": "ACWORTH",
            "state": "GA",
            "postal_code": "301018089",
            "telephone_number": "770-529-1925",
            "fax_number": "770-529-1982"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1720 MARS HILL RD NW STE 160",
            "city": "ACWORTH",
            "state": "GA",
            "postal_code": "301018089",
            "telephone_number": "770-529-1925",
            "fax_number": "770-529-1982"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYECONTACT INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-03",
        "last_updated": "2019-01-15",
        "status": "A",
        "authorized_official_last_name": "MOBLEY",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "WESLEY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "770-529-1925",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "GA",
            "license": "2200",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "763412534A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Acworth, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 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.