Individual provider Active NPI

Charles Stephen Helms, O.D.

  • Optometrist
  • Marietta, GA
National Provider Identifier
1427129600
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
983 Issued in GA
Practice address
1550 Longwood Dr SW
Marietta, GA 30008-3786
Phone
(770) 428-3530
Fax
(770) 792-9196
NPI assigned
Nov 10, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 983 GA Primary

Addresses

Primary practice location

1550 Longwood Dr SW
Marietta, GA 30008-3786

Mailing address

1550 Longwood Dr SW
Marietta, GA 30008-3786
Phone (770) 428-3530

Other identifiers 1

IdentifierTypeStateIssuer
00358806AMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210323001815 GA Practitioner - Optometry 9133536949

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
983GAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
MC DO Optometry LLC Optometrist Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1163116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1427129600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1550 LONGWOOD DR SW",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300083786",
            "telephone_number": "770-428-3530",
            "fax_number": "770-792-9196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1550 LONGWOOD DR SW",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300083786",
            "telephone_number": "770-428-3530",
            "fax_number": "770-792-9196"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HELMS",
        "first_name": "CHARLES",
        "middle_name": "STEPHEN",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "GA",
            "license": "983",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00358806A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Marietta, GA

Sources for this page

Verify at the official NPI Registry.