NPIMap

Organization Active NPI

Professional Eye Associates, Inc.

  • Eyewear Supplier
  • Chatsworth, GA
National Provider Identifier
1578079869
Registry record updated Dec 21, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Eyewear SupplierTaxonomy code 332H00000X
Legal business name
PROFESSIONAL EYE ASSOCIATES, INC.
Practice address
113 West Pine Street
Chatsworth, GA 30705
Phone
(706) 226-2020
Fax
(706) 529-3322
NPI assigned
Dec 21, 2017
Organization subpart
Yes
Parent organization
PROFESSIONAL EYE ASSOCIATES, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 21, 2017

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

Authorized official

Name
Sandra D Curd, MBA
Title
Chief Operations Officer
Phone
(706) 226-2020

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Eyewear Supplier 332H00000X GA Primary

Addresses

Primary practice location

113 West Pine Street
Chatsworth, GA 30705

Mailing address

1111 Professional Blvd
Dalton, GA 30720
Phone (706) 226-2020

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190404000237 GA DME Supplier - Optician 4789677071 Practice locations: Chatsworth, GA

Other NPIs with the same Medicare PAC ID 5

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Professional Eye Associates, Inc.113 W Pine St, Chatsworth, GA 30705-2923(706) 226-2020 Prosthetic Lenses: Conventional Eyeglasses|Prosthetic Lenses: Conventional Contact Lenses Accepts assignmentParticipating since Jan 1, 2001

National Provider Directory

National Provider Directory
Tax ID family
Professional Eye Associates6 organizations share this tax ID, including this one
Part of
Professional Eye Associates

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

Locations

400 Maddox Dr
Ellijay, GA 30540
Phone (706) 276-4455

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1513814400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1513814400000",
    "number": "1578079869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 PROFESSIONAL BLVD",
            "city": "DALTON",
            "state": "GA",
            "postal_code": "30720",
            "telephone_number": "706-226-2020",
            "fax_number": "706-529-3322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "113 WEST PINE STREET",
            "city": "CHATSWORTH",
            "state": "GA",
            "postal_code": "30705",
            "telephone_number": "706-226-2020",
            "fax_number": "706-529-3322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROFESSIONAL EYE ASSOCIATES, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PROFESSIONAL EYE ASSOCIATES, INC.",
        "enumeration_date": "2017-12-21",
        "last_updated": "2017-12-21",
        "status": "A",
        "authorized_official_last_name": "CURD",
        "authorized_official_first_name": "SANDRA",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "CHIEF OPERATIONS OFFICER",
        "authorized_official_telephone_number": "706-226-2020",
        "authorized_official_credential": "MBA"
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "GA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chatsworth, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.

Verify at the official NPI Registry.