NPIMap

Organization Active NPI

Eastmetro Eyecare P.C.

  • Optometrist
  • Conyers, GA
National Provider Identifier
1467524090
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
796 Issued in GA
Legal business name
EASTMETRO EYECARE P.C.
Practice address
1013 E Freeway Dr SE
Conyers, GA 30094-5965
Phone
(770) 922-7906
Fax
(770) 483-0498
NPI assigned
Nov 15, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mrs. Timmie Bailey
Title
Insurance
Phone
(770) 922-7906

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 796 GA Primary

Addresses

Primary practice location

1013 E Freeway Dr SE
Conyers, GA 30094-5965

Mailing address

1013 E Freeway Dr SE
Conyers, GA 30094-5965
Phone (770) 922-7906

Other identifiers 2

IdentifierTypeStateIssuer
VGA001657OtherGAAVESIS
GA0796OtherGAEYEMED

National Provider Directory

National Provider Directory

Locations

1013 E Freeway Dr SE
Conyers, GA 30094
Phone (770) 922-7906

NPI Registry JSON

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

{
    "created_epoch": "1163548800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1467524090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1013 E FREEWAY DR SE",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300945965",
            "telephone_number": "770-922-7906",
            "fax_number": "770-483-0498"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1013 E FREEWAY DR SE",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300945965",
            "telephone_number": "770-922-7906",
            "fax_number": "770-483-0498"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EASTMETRO EYECARE P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-15",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BAILEY",
        "authorized_official_first_name": "TIMMIE",
        "authorized_official_title_or_position": "INSURANCE",
        "authorized_official_telephone_number": "770-922-7906",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "GA",
            "license": "796",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AVESIS",
            "identifier": "VGA001657",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EYEMED",
            "identifier": "GA0796",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Conyers, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.