Individual provider Active NPI

Joseph Rouw, OD, FAAO, FCOVD

  • Optometrist
  • Dacula, GA
National Provider Identifier
1497753701
Registry record updated Apr 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2353 Issued in GA
Practice address
2055 Hamilton Creek Pkwy Ste 120
Dacula, GA 30019-7205
Phone
(770) 904-0979
Fax
(470) 655-7914
NPI assigned
Jul 11, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1441 SC
Optometrist 152W00000X 2581 TN
Optometrist 152W00000X 2353 GA Primary

Addresses

Primary practice location

2055 Hamilton Creek Pkwy Ste 120
Dacula, GA 30019-7205

Mailing address

3518 Habersham Club Dr
Cumming, GA 30041-8003
Phone (678) 448-2854

Other practice location 1

2920 Ronald Reagan Blvd Ste 104
Cumming, GA 30041-7578
Phone (770) 904-0979

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2353GAMDOptometrist
1441SCMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Pediatric Vision Development Center of Forsyth PastSince Oct 1, 2022 Accepting new patients
Hamilton Mill Eyecare Inc. Optometrist PastSince Aug 7, 1996 Accepting new patients
Pediatric Vision Development Center of Gwinnett PastSince Apr 27, 2025 Accepting new patients
Myeyedr Optometry of Georgia, LLC Optometrist Past Accepting new patients

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": "1121040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745452800000",
    "number": "1497753701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3518 HABERSHAM CLUB DR",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300418003",
            "telephone_number": "678-448-2854"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2055 HAMILTON CREEK PKWY STE 120",
            "city": "DACULA",
            "state": "GA",
            "postal_code": "300197205",
            "telephone_number": "770-904-0979",
            "fax_number": "470-655-7914"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2920 Ronald Reagan Blvd Ste 104",
            "address_purpose": "LOCATION",
            "city": "Cumming",
            "state": "GA",
            "postal_code": "300417578",
            "country_code": "US",
            "telephone_number": "770-904-0979",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROUW",
        "first_name": "JOSEPH",
        "credential": "OD, FAAO, FCOVD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-11",
        "last_updated": "2025-04-24",
        "certification_date": "2025-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "SC",
            "license": "1441",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TN",
            "license": "2581",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "GA",
            "license": "2353",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dacula, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2025; 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.