Individual provider Active NPI

Peyton Taylor, OD

  • Optometrist
  • Hiram, GA
National Provider Identifier
1598589459
Registry record updated Nov 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT003628 Issued in GA
Practice address
4373 Jimmy Lee Smith Pkwy Ste 101
Hiram, GA 30141-2642
Phone
(770) 943-2220
NPI assigned
Nov 7, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPT003628 GA Primary

Addresses

Primary practice location

4373 Jimmy Lee Smith Pkwy Ste 101
Hiram, GA 30141-2642

Mailing address

4373 Jimmy Lee Smith Pkwy Ste 101
Hiram, GA 30141-2642

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
I20241226003142 GA Practitioner - Optometry 2961939228 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPT003628GAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Ga Doctors of Optometry LLC Optometrist CurrentSince Nov 8, 2024 Accepting new patients
Ga Doctors of Optometry LLC Optometrist CurrentSince Nov 8, 2024 Accepting new patients

Locations

50 Main Street Market Pl SE
Ste 100
Cartersville, GA 30121
Phone (770) 382-6379

4373 Jimmy Lee Smith Pkwy
Ste 101
Hiram, GA 30141
Phone (770) 943-2220

Organizations & group practices 2

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": "1730937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730937600000",
    "number": "1598589459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4373 JIMMY LEE SMITH PKWY STE 101",
            "city": "HIRAM",
            "state": "GA",
            "postal_code": "301412642"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4373 JIMMY LEE SMITH PKWY STE 101",
            "city": "HIRAM",
            "state": "GA",
            "postal_code": "301412642",
            "telephone_number": "770-943-2220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAYLOR",
        "first_name": "PEYTON",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-11-07",
        "last_updated": "2024-11-07",
        "certification_date": "2024-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "GA",
            "license": "OPT003628",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hiram, GA

Sources for this page

Verify at the official NPI Registry.