Premier Vision Services

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

PREMIER VISION SERVICES

Practice address

2305 English Ivy CT SE
Atlanta, GA 30339-6797

Phone

(917) 250-4468

NPI assigned

Nov 18, 2024

Last updated

Mar 24, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Malique Payne, ODNPI 1457546376

Title

Owner

Phone

(917) 250-4468

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Malique Roxanne Payne, O.D.

  • Optometrist
  • Fayetteville, GA
  • NPI 1457546376
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1731888000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1742774400000",
    "number": "1508681289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2305 ENGLISH IVY CT SE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303396797",
            "telephone_number": "917-250-4468"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2305 ENGLISH IVY CT SE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303396797",
            "telephone_number": "917-250-4468"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER VISION SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-11-18",
        "last_updated": "2025-03-24",
        "certification_date": "2025-03-24",
        "status": "A",
        "authorized_official_last_name": "PAYNE",
        "authorized_official_first_name": "MALIQUE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "917-250-4468",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Premise Health of Georgia Medical PC (Children's Employee Health Scottish Rite)
• Premise Health of Georgia Medical PC (Warner Bros. Discovery Health & Wellness Center at CNN Center)
• Premise Health of Georgia Medical PC (AT&T Atlanta)

• Optometrist in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Optometrist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.