Individual provider Active NPI

Donna G Whitlow, O.D.

  • Optometrist
  • Lagrange, GA
National Provider Identifier
1528053618
Registry record updated Oct 17, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT001300 Issued in GA
Practice address
407 S Greenwood St
Lagrange, GA 30240-3123
Phone
(706) 882-0616
Fax
(706) 882-8515
NPI assigned
Sep 14, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPT001300 GA Primary

Addresses

Primary practice location

407 S Greenwood St
Lagrange, GA 30240-3123

Mailing address

407 S Greenwood St
Lagrange, GA 30240-3123
Phone (706) 882-0616

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
I20101118000015 GA Practitioner - Optometry 8820181654 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University Alabama Birmingham - School of Optometry, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
John B. Whitlow, O.D.P.C.Group PAC ID 7012906480, 2 clinicians

Practice addresses (Care Compare)

407 S Greenwood St
Lagrange, GA 30240-3123
Phone (706) 882-0616

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
John B. Whitlow, O.D.P.C. Optometrist CurrentSince May 10, 1993 Accepting new patients

Locations

407 S Greenwood St
Lagrange, GA 30240
Phone (706) 882-0616

Organizations & group practices 1

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": "1126656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1192579200000",
    "number": "1528053618",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "407 S GREENWOOD ST",
            "city": "LAGRANGE",
            "state": "GA",
            "postal_code": "302403123",
            "telephone_number": "706-882-0616",
            "fax_number": "706-882-8515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "407 S GREENWOOD ST",
            "city": "LAGRANGE",
            "state": "GA",
            "postal_code": "302403123",
            "telephone_number": "706-882-0616",
            "fax_number": "706-882-8515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITLOW",
        "first_name": "DONNA",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-14",
        "last_updated": "2007-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "GA",
            "license": "OPT001300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lagrange, GA

Sources for this page

Verify at the official NPI Registry.