Individual provider Active NPI

Zakiya Oni Nicks, OD

  • Optometrist
  • Memphis, TN
National Provider Identifier
1518122159
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2776 Issued in TN
Practice address
1225 Madison Ave
Memphis, TN 38104-2211
Phone
(901) 722-3250
Fax
(901) 722-3347
NPI assigned
Jul 23, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2776 TN Primary

Addresses

Primary practice location

1225 Madison Ave
Memphis, TN 38104-2211

Mailing address

1245 Madison Ave
Memphis, TN 38104-2211
Phone (901) 722-3250

Other identifiers 2

IdentifierTypeStateIssuer
1506564MedicaidTN
2776OtherTNOD

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
I20180816002248 GA Practitioner - Optometry 6507931953 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University Alabama Birmingham - School of Optometry, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Marietta Eye Clinic, PAGroup PAC ID 0143210427, 39 clinicians

Practice addresses (Care Compare)

895 Canton Rd NE
BLDG 100
Marietta, GA 30060-8935
Phone (770) 427-8111

Merit-based Incentive Payment System (MIPS)

Final score
93.93 of 100Reported as apm
Quality
82.14
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2776TNMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Marietta Eye Clinic PA CurrentSince Jul 30, 2018 Accepting new patients
Marietta Eye Clinic PA CurrentSince Jul 30, 2018 Accepting new patients
Marietta Eye Clinic, PA Optometrist Past Accepting new patients
Marietta Eye Clinic, PA Past Accepting new patients

Locations

4450 Calibre Xing NW
Ste 1104
Acworth, GA 30101
Phone (678) 279-1141

100 Old Ball Ground Hwy
#A
Canton, GA 30114

100 Old Ball Ground Hwy
Canton, GA 30114
Phone (770) 479-2195

8841 Hospital Dr
Douglasville, GA 30134
Phone (770) 577-2200

47 Highland Pavilion Ct
Ste 101
Hiram, GA 30141

3939 Roswell Rd
Ste 100
Marietta, GA 30062
Phone (770) 977-8000

1950 Spectrum Cir SE
Ste 150
Marietta, GA 30067
Phone (770) 952-6851

2520 Windy Hill Rd SE
Ste 206
Marietta, GA 30067
Phone (770) 952-6851

2453 Powder Springs Rd SW
Ste 400
Marietta, GA 30064
Phone (770) 801-0700

895 Canton Rd NE
Bldg 100
Marietta, GA 30060
Phone (770) 425-6167

4025 Johns Creek Pkwy
Ste 200
Suwanee, GA 30024
Phone (678) 439-2450

2990 Eagle Dr
Ste 110
Woodstock, GA 30189
Phone (678) 460-4810

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1216771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1518122159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1245 MADISON AVE",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381042211",
            "telephone_number": "901-722-3250",
            "fax_number": "901-722-3347"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1225 MADISON AVE",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381042211",
            "telephone_number": "901-722-3250",
            "fax_number": "901-722-3347"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICKS",
        "first_name": "ZAKIYA",
        "middle_name": "ONI",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-23",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TN",
            "license": "2776",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1506564",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OD",
            "identifier": "2776",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

Verify at the official NPI Registry.