Individual provider Active NPI

John Michael Simmons Jr., O.D.

  • Optometrist
  • Macon, GA
National Provider Identifier
1598733222
Registry record updated Jun 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT001571 Issued in GA
Practice address
4050 Riverside Dr
Macon, GA 31210-1805
Phone
(478) 744-1710
NPI assigned
Mar 9, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 20, 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 OPT001571 GA Primary

Addresses

Primary practice location

4050 Riverside Dr
Macon, GA 31210-1805

Mailing address

4050 Riverside Dr
Macon, GA 31210-1805
Phone (478) 744-1710

Other practice location 1

151 S Houston Lake Rd Ste 190
Warner Robins, GA 31088-6382
Phone (478) 744-1710

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
I20120424000219 GA Practitioner - Optometry 8426009440 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Vision Eye Group Houston County LLCGroup PAC ID 8628516283, 2 clinicians
Vision Eye GroupGroup PAC ID 0345581229, 7 clinicians

Practice addresses (Care Compare)

151 S Houston Lake Rd
Suite 190
Warner Robins, GA 31088-6382
Phone (478) 744-1710

4050 Riverside Dr
Macon, GA 31210-1805
Phone (478) 744-1710

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1571GAMDPhysical Medicine & Rehabilitation Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Vision Eye Group CurrentSince Jul 1, 2022 Accepting new patients
Myeyedr Optometry of Georgia, LLC Optometrist CurrentSince Nov 6, 2017 Accepting new patients
Vision Eye Group - Warner Robins LLC Current Accepting new patients
Myeyedr Optometry of Georgia, LLC Optometrist CurrentSince Nov 6, 2017 Accepting new patients
Myeyedr Optometry of Georgia, LLC Optometrist Current Accepting new patients
Vision Eye Group Houston County LLC Optometrist CurrentSince Jul 1, 2024 Accepting new patients

Locations

4875 Altama Ave
Brunswick, GA 31520
Phone (912) 554-0010

4050 Riverside Dr
Macon, GA 31210
Phone (478) 744-1710

3801 Northside Dr
Macon, GA 31210
Phone (478) 475-1600

151 S Houston Lake Rd
Ste 190
Warner Robins, GA 31088
Phone (478) 744-1710

198 S Houston Lake Rd
Ste B
Warner Robins, GA 31088
Phone (478) 971-1500

1950 Old Gallows Rd
Ste 520
Vienna, VA 22182

8614 Westwood Center Dr
Fl 9
Vienna, VA 22182

Interoperability endpoints

  • Direct secure messaging: john.simmons@1485.chartlogic.direct-ci.com

Organizations & group practices 6

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": "1141862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718841600000",
    "number": "1598733222",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4050 RIVERSIDE DR",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312101805",
            "telephone_number": "478-744-1710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4050 RIVERSIDE DR",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312101805",
            "telephone_number": "478-744-1710"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "151 S Houston Lake Rd Ste 190",
            "address_purpose": "LOCATION",
            "city": "Warner Robins",
            "state": "GA",
            "postal_code": "310886382",
            "country_code": "US",
            "telephone_number": "478-744-1710",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SIMMONS",
        "first_name": "JOHN",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-09",
        "last_updated": "2024-06-20",
        "certification_date": "2024-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "GA",
            "license": "OPT001571",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Macon, GA

Sources for this page

Verify at the official NPI Registry.