Active NPI
Mier Wang, O.D
- Optometrist
- Athens, GA
National Provider Identifier
1407974082
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 1517
- Practice address
- 3700 Atlanta Hwy Ste 141
Athens, GA 30606-7420 - Phone
- (706) 613-6409
- Fax
- (706) 613-6409
- NPI assigned
- Mar 26, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 1517 | GA | Primary |
Addresses
Primary practice location
3700 Atlanta Hwy Ste 141
Athens, GA 30606-7420
Mailing address
810 Golf View CT
Dacula, GA 30019-6732
Phone (678) 376-8488
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00732685B | Medicaid | GA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1517 | GA | MD | Optometrist |
| 001517 | GA | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174867200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1407974082",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "810 GOLF VIEW CT",
"city": "DACULA",
"state": "GA",
"postal_code": "300196732",
"telephone_number": "678-376-8488",
"fax_number": "706-613-5514"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3700 ATLANTA HWY STE 141",
"city": "ATHENS",
"state": "GA",
"postal_code": "306067420",
"telephone_number": "706-613-6409",
"fax_number": "706-613-6409"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WANG",
"first_name": "MIER",
"credential": "O.D",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-26",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "GA",
"license": "1517",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00732685B",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Athens, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.