John C.Vencill O.D., P.C.

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

JOHN C.VENCILL O.D., P.C.

Practice address

1400 Hudson Bridge Rd
Stockbridge, GA 30281-5018

Phone

(678) 485-8906

Fax

(770) 474-0698

NPI assigned

Apr 24, 2008

Organization subpart

No

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

Authorized official

Name

Dr. John C Vencill, O.D.

Title

President

Phone

(678) 485-8906

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1208995200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1618531200000",
    "number": "1447425129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2933 SUMMIT DR",
            "city": "JONESBORO",
            "state": "GA",
            "postal_code": "302366252",
            "telephone_number": "678-485-8906",
            "fax_number": "770-222-6691"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 HUDSON BRIDGE RD",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "302815018",
            "telephone_number": "678-485-8906",
            "fax_number": "770-474-0698"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHN C.VENCILL O.D., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-24",
        "last_updated": "2021-04-16",
        "certification_date": "2021-04-16",
        "status": "A",
        "authorized_official_last_name": "VENCILL",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "678-485-8906",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Optometrist in Stockbridge, GA
• Providers in Stockbridge, GA by specialty
• Optometrist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2021; 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.