Individual provider Active NPI

Stuart Jackson Thomas, OD

  • Optometrist
  • Athens, GA
National Provider Identifier
1568436186
Registry record updated Dec 9, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
GA1062 Issued in GA
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

Updated by the provider on Dec 9, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
00314388AMedicaidGA

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
I20060329000640 GA Practitioner - Optometry 1759399926 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Athens Eye Care LLCGroup PAC ID 0547792418, 3 clinicians

Practice addresses (Care Compare)

1077 Baxter St
Suite 100
Athens, GA 30606-3767
Phone (706) 549-7757

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery33

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
001062GAMDMarriage & Family Therapist
GA1062GAMDOptometrist
GA 1062GAMDSports Vision Optometrist
1062GAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Thomas Eye Center Optometrist CurrentSince Jan 1, 2008 Accepting new patients
Athens Eye Care LLC Optometrist CurrentSince Jul 31, 2024 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

  • FHIR API: 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.

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

Verify at the official NPI Registry.