Individual provider Active NPI

Daniel James McBride, OD

  • Optometrist
  • Dalton, GA
National Provider Identifier
1629030903
Registry record updated Dec 5, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT002233 Issued in GA
Practice address
1111 Professional Blvd
Dalton, GA 30720-2588
Phone
(706) 226-2020
Fax
(706) 217-2876
NPI assigned
Apr 4, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPT002233 GA Primary

Addresses

Primary practice location

1111 Professional Blvd
Dalton, GA 30720-2588

Mailing address

1111 Professional Blvd
Dalton, GA 30720-2588
Phone (706) 226-2020

Other identifiers 1

IdentifierTypeStateIssuer
296895566AMedicaidGA

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
I20050817000400 GA Practitioner - Optometry 5294765459 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Professional Eye Associates, Inc.Group PAC ID 4789677071, 7 clinicians

Practice addresses (Care Compare)

101 Professional CT SE
Calhoun, GA 30701-7036
Phone (404) 783-5975

Merit-based Incentive Payment System (MIPS)

Final score
93.41 of 100Reported as group
Quality
100
Improvement activities
40
Cost
78.03

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPT002233GAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Professional Eye Associates, Inc. CurrentSince Jun 30, 2005 Accepting new patients
Professional Eye Associates, Inc. CurrentSince Jun 30, 2005 Accepting new patients
Professional Eye Associates, Inc. Optometrist Past Accepting new patients
Professional Eye Associates, Inc. Past Accepting new patients

Locations

101 Professional Ct SE
Calhoun, GA 30701
Phone (404) 783-5975

113 W Pine St
Chatsworth, GA 30705
Phone (706) 226-2020

1111 Professional Blvd
Dalton, GA 30720
Phone (404) 226-2232

2498 Lafayette Rd
Ft Oglethorpe, GA 30742
Phone (706) 866-2020

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": "1144108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1228435200000",
    "number": "1629030903",
    "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": "307202588",
            "telephone_number": "706-226-2020",
            "fax_number": "706-217-2876"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 PROFESSIONAL BLVD",
            "city": "DALTON",
            "state": "GA",
            "postal_code": "307202588",
            "telephone_number": "706-226-2020",
            "fax_number": "706-217-2876"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCBRIDE",
        "first_name": "DANIEL",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-04",
        "last_updated": "2008-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "GA",
            "license": "OPT002233",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "296895566A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dalton, GA

Sources for this page

Verify at the official NPI Registry.