Individual provider Active NPI

Brandy Carroll Augustine, O.D.

  • Optometrist
  • Marietta, GA
National Provider Identifier
1457404170
Registry record updated Dec 6, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2421 Issued in GA
Practice address
895 Canton Rd NE
#100
Marietta, GA 30060-8934
Phone
(770) 427-8111
NPI assigned
Jan 18, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2421 GA Primary

Addresses

Primary practice location

895 Canton Rd NE
#100
Marietta, GA 30060-8934

Mailing address

3427 River Heights Xing SE
Marietta, GA 30067-4892
Phone (678) 654-6440

Other names 1

  • Dr. Brandy Michelle Carroll Former name

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
I20110705000368 GA Practitioner - Optometry 7416135991 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Marietta Eye Clinic, PAGroup PAC ID 0143210427, 39 clinicians

Practice addresses (Care Compare)

10485 Alpharetta St
Roswell, GA 30075-3757
Phone (678) 439-2443

1950 Spectrum Cir SE
Suite 150
Marietta, GA 30067-8479
Phone (770) 952-6851

895 Canton Rd NE
BLDG 100
Marietta, GA 30060-8935
Phone (770) 427-8111

Merit-based Incentive Payment System (MIPS)

Final score
93.93 of 100Reported as apm
Quality
82.14
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2421GAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Marietta Eye Clinic PA CurrentSince Jul 11, 2011 Accepting new patients
Marietta Eye Clinic PA Current Accepting new patients
Marietta Eye Clinic, PA Optometrist CurrentSince Jul 11, 2011 Accepting new patients
Marietta Eye Clinic, PA Past Accepting new patients

Locations

47 Highland Pavilion Ct
Ste 101
Atlanta, GA 31193

3939 Roswell Rd
Ste 100
Marietta, GA 30062
Phone (770) 977-8000

1950 Spectrum Cir SE
Ste 150
Marietta, GA 30067
Phone (770) 952-6851

2520 Windy Hill Rd SE
Ste 206
Marietta, GA 30067
Phone (770) 952-6851

2453 Powder Springs Rd SW
Ste 400
Marietta, GA 30064
Phone (770) 801-0700

895 Canton Rd NE
Bldg 100
Marietta, GA 30060
Phone (770) 425-6167

10485 Alpharetta St
Roswell, GA 30075
Phone (678) 439-2443

4025 Johns Creek Pkwy
Ste 200
Suwanee, GA 30024
Phone (678) 439-2450

2990 Eagle Dr
Ste 110
Woodstock, GA 30189
Phone (678) 460-4810

Organizations & group practices 4

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": "1169078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323129600000",
    "number": "1457404170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3427 RIVER HEIGHTS XING SE",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300674892",
            "telephone_number": "678-654-6440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "895 CANTON RD NE",
            "address_2": "#100",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300608934",
            "telephone_number": "770-427-8111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AUGUSTINE",
        "first_name": "BRANDY",
        "middle_name": "CARROLL",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-18",
        "last_updated": "2011-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "GA",
            "license": "2421",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BRANDY",
            "last_name": "CARROLL",
            "middle_name": "MICHELLE",
            "prefix": "DR.",
            "credential": "O.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Marietta, GA

Sources for this page

Verify at the official NPI Registry.