Individual provider Active NPI

Chris Hobson, O.D.

  • Optometrist
  • Kennesaw, GA
National Provider Identifier
1467421073
Registry record updated Feb 5, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT000797 Issued in GA
Practice address
1415 Wooten Lake Rd NW
Suite 100
Kennesaw, GA 30144-1350
Phone
(770) 424-2020
Fax
(770) 424-8242
NPI assigned
Mar 16, 2006
Last updated
Feb 5, 2009By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 5, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPT000797 GA Primary

Addresses

Primary practice location

1415 Wooten Lake Rd NW
Suite 100
Kennesaw, GA 30144-1350

Mailing address

1415 Wooten Lake Rd NW
Suite 100
Kennesaw, GA 30144-1350
Phone (770) 424-2020

Other identifiers 1

IdentifierTypeStateIssuer
000230392BMedicaidGA

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
I20090309000178 GA Practitioner - Optometry 1355384918 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPT000797GAMDOptometrist
797GAMDContractor

Practice roles

OrganizationSpecialtyStatusNew patients
Myeyedr Optometry of Georgia, LLC Optometrist CurrentSince Jan 15, 2019 Accepting new patients
Myeyedr Optometry of Georgia, LLC Optometrist CurrentSince Jan 15, 2019 Accepting new patients
H & T Eye Group, LLC Optometrist PastSince Jul 1, 1996 Accepting new patients

Locations

4875 Altama Ave
Brunswick, GA 31520
Phone (912) 554-0010

1415 Wooten Lake Rd NW
Ste 100
Kennesaw, GA 30144
Phone (770) 424-2020

1950 Old Gallows Rd
Ste 520
Vienna, VA 22182

8614 Westwood Center Dr
Fl 9
Vienna, VA 22182

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1142467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1233792000000",
    "number": "1467421073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1415 WOOTEN LAKE RD NW",
            "address_2": "SUITE 100",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301441350",
            "telephone_number": "770-424-2020",
            "fax_number": "770-424-8242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1415 WOOTEN LAKE RD NW",
            "address_2": "SUITE 100",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301441350",
            "telephone_number": "770-424-2020",
            "fax_number": "770-424-8242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOBSON",
        "first_name": "CHRIS",
        "name_prefix": "Mr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-16",
        "last_updated": "2009-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "GA",
            "license": "OPT000797",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000230392B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kennesaw, GA

Sources for this page

Verify at the official NPI Registry.