Individual provider Active NPI

Camilla Donald, O.D.

  • Optometrist
  • Alpharetta, GA
National Provider Identifier
1477541126
Registry record updated Oct 7, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT002026 Issued in GA
Practice address
10600 Davis Dr
Alpharetta, GA 30009-4746
Phone
(770) 992-6811
NPI assigned
Oct 7, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 7, 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 OPT002026 GA Primary

Addresses

Primary practice location

10600 Davis Dr
Alpharetta, GA 30009-4746

Mailing address

270 Cobb Pkwy S
Suite a-10a#264
Marietta, GA 30060-9320
Phone (404) 519-7567

Other identifiers 1

IdentifierTypeStateIssuer
003109625AMedicaidGA

Other names 1

  • Dr. Camilla Jones 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
I20061003000069 GA Practitioner - Optometry 3870598576 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of Missouri St Louis - School of Optometry, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Eye MDGroup PAC ID 2466877865, 2 clinicians
Select Eyecare, LLCGroup PAC ID 8527431733, 2 clinicians

Practice addresses (Care Compare)

1307 Milstead Ave NE
Conyers, GA 30012-3829
Phone (770) 691-5176

4221 Atlanta Hwy
Loganville, GA 30052-7316
Phone (478) 368-5385

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPT002026GAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Select Eyecare LLC Optometrist CurrentSince Sep 17, 2024 Accepting new patients
State of Mississippi - University of Mississippi Medical Center Past Accepting new patients

Locations

10300 Industrial Blvd NE
Covington, GA 30014
Phone (770) 787-8030

4221 Atlanta Hwy
Loganville, GA 30052
Phone (478) 368-5385

2050 W Spring St
Monroe, GA 30655
Phone (478) 368-5386

Organizations & group practices 3

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": "1128643200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317945600000",
    "number": "1477541126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "270 COBB PKWY S",
            "address_2": "SUITE A-10A#264",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300609320",
            "telephone_number": "404-519-7567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10600 DAVIS DR",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300094746",
            "telephone_number": "770-992-6811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DONALD",
        "first_name": "CAMILLA",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-07",
        "last_updated": "2011-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "GA",
            "license": "OPT002026",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003109625A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CAMILLA",
            "last_name": "JONES",
            "prefix": "DR.",
            "credential": "O.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Alpharetta, GA

Sources for this page

Verify at the official NPI Registry.