Active NPI
Stuart Jackson Thomas, OD
- Optometrist
- Athens, GA
National Provider Identifier
1568436186
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- GA1062
- Practice address
- 1077 Baxter St
Athens, GA 30606-3767 - Phone
- (706) 549-7757
- Fax
- (706) 549-4186
- NPI assigned
- Feb 13, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Sports Vision Optometrist | 152WS0006X | GA 1062 | GA | |
| Optometrist | 152W00000X | GA1062 | GA | Primary |
Addresses
Primary practice location
1077 Baxter St
Athens, GA 30606-3767
Mailing address
1077 Baxter St
Athens, GA 30606-3767
Phone (706) 549-7757
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00314388A | Medicaid | GA |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Optometry
- Education
- Other, 1981
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1077 Baxter St
Suite 100
Athens, GA 30606-3767
Phone (706) 549-7757
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Cataract surgery | 33 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 001062 | GA | MD | Marriage & Family Therapist |
| GA1062 | GA | MD | Optometrist |
| GA 1062 | GA | MD | Sports Vision Optometrist |
| 1062 | GA | MD | Medical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Thomas Eye Center | Optometrist | Current | Accepting new patients |
| Athens Eye Care LLC | Optometrist | Current | Accepting new patients |
| Southeast Eye Surgery Center, PC | Past | Accepting new patients | |
| Thomas Eye Center | Optometrist | Past | Accepting new patients |
Locations
1077 Baxter St
Ste 100
Athens, GA 30606
Phone (706) 549-7757
Interoperability endpoints
- https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
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.
-
- Optometrist
- Athens, GA
- NPI 1871335240
-
- Optometrist
- Athens, GA
- NPI 1063683381
-
- Ophthalmology Physician
- Atlanta, GA
- NPI 1629120928
-
- Optometrist
- Athens, GA
- NPI 1700096021
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1139788800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1386547200000",
"number": "1568436186",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1077 BAXTER ST",
"city": "ATHENS",
"state": "GA",
"postal_code": "306063767",
"telephone_number": "706-549-7757",
"fax_number": "706-549-4186"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1077 BAXTER ST",
"city": "ATHENS",
"state": "GA",
"postal_code": "306063767",
"telephone_number": "706-549-7757",
"fax_number": "706-549-4186"
}
],
"practiceLocations": [],
"basic": {
"last_name": "THOMAS",
"first_name": "STUART",
"middle_name": "JACKSON",
"name_prefix": "Dr.",
"credential": "OD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-02-13",
"last_updated": "2013-12-09",
"status": "A"
},
"taxonomies": [
{
"code": "152WS0006X",
"taxonomy_group": "",
"desc": "Optometrist, Sports Vision",
"state": "GA",
"license": "GA 1062",
"primary": false
},
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "GA",
"license": "GA1062",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00314388A",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Athens, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.