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

Last updated

Apr 16, 2021By the provider in NPPES

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.NPI 1730283904

Title

President

Phone

(678) 485-8906

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• John C Vencill, O.D.

  • Optometrist
  • Stockbridge, GA
  • NPI 1730283904
  Authorized official Same address or phone

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": []
}

• Ronald Christopher Jett II
• Jewel ABA Therapy
• Jla3 Services LLC
• JLM Dentistry of Stockbridge
• Lee C Joassin
• Tamika Johnnicans, NURSE PRACTITIONER
• C J Johnson, PSYD
• Candace J Johnson, M.D.
• Candice Johnson
• Charla V Johnson, PA-C

• 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.