Bolt Eye Group-East Cobb LLC

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

BOLT EYE GROUP-EAST COBB LLC

Practice address

2255 Sewell Mill Rd #310
Marietta, GA 30062

Phone

(770) 578-1900

Fax

(770) 578-2263

NPI assigned

Jul 29, 2022

Last updated

Aug 16, 2022By 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

Barbara Williams

Title

Billing Specialist/Office Manager

Phone

(770) 776-9000

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Locations

Practitioners 8

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.

• Jaymini Nayee, O.D.

  • Optometrist
  • Marietta, GA
  • NPI 1447415732
  Medicare reassignment NPD
• Beth Wingate Seay, O.D.

  • Optometrist
  • Atlanta, GA
  • NPI 1811148588
  Medicare reassignment NPD
• Carrie Leigh Hughes

  • Optometrist
  • Roswell, GA
  • NPI 1194167098
  NPD
• Jeffrey Glenn Jeruss, O.D.

  • Optometrist
  • Marietta, GA
  • NPI 1508055732
  NPD
• Pete Chris Kevin Huffman, O.D.

  • Optometrist
  • Dallas, GA
  • NPI 1679759849
  NPD (past)
• Teri D. Hung, O.D.

  • Optometrist
  • Alpharetta, GA
  • NPI 1598777179
  NPD (past)
• Susan Marie Reimbold, O.D.

  • Optometrist
  • Alpharetta, GA
  • NPI 1033236492
  NPD (past)
• Amber C Zaunbrecher, O.D.

  • Optometrist
  • Atlanta, GA
  • NPI 1922391903
  NPD (past)

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

{
    "created_epoch": "1659052800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1660608000000",
    "number": "1548996754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4180 OLD MILTON PARKWAY",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "30005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2255 SEWELL MILL RD #310",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "30062",
            "telephone_number": "770-578-1900",
            "fax_number": "770-578-2263"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOLT EYE GROUP-EAST COBB LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-07-29",
        "last_updated": "2022-08-16",
        "certification_date": "2022-08-16",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "BARBARA",
        "authorized_official_title_or_position": "BILLING SPECIALIST/OFFICE MANAGER",
        "authorized_official_telephone_number": "770-776-9000"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mac Kenzie Hunter Bohns
• Bold Legacy Practice, LLC
• Bold Legacy Practice, LLC (American Family Care)
• Bold Primary LLC (American Family Care)
• Carol Bayless Bolden, D.M.D.
• Karen Bolton
• Priscilla Alden Bolton, RN
• Adam Wesley Bomar, FNP-C
• Latrice Bond
• Janet Lynne Boner, M.ED.,MT-BC, NICU MT

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2022; 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.