Charles Ray Popham, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

864 Issued in GA

Practice address

206 Main St
Cedartown, GA 30125-3040

Phone

(770) 748-2443

Fax

(770) 748-8885

NPI assigned

Aug 16, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Popham Eyecare LLC

  • Optometrist
  • Cedartown, GA
  • NPI 1790258374
  NPD

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

{
    "created_epoch": "1124150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1629060728",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "206 MAIN ST",
            "city": "CEDARTOWN",
            "state": "GA",
            "postal_code": "301253040",
            "telephone_number": "770-748-2443",
            "fax_number": "770-748-8885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "206 MAIN ST",
            "city": "CEDARTOWN",
            "state": "GA",
            "postal_code": "301253040",
            "telephone_number": "770-748-2443",
            "fax_number": "770-748-8885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POPHAM",
        "first_name": "CHARLES",
        "middle_name": "RAY",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-16",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "GA",
            "license": "864",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Polk Medical Center, Inc
• Polk Medical Center, Inc
• Polk School District
• Jhinora Pollard
• Popham Eyecare LLC
• John Thomas Popham
• Praise Pediatric Therapy LLC
• Kyra Prashaw, BCABA
• Charity Prater
• Janet Prater

• Optometrist in Cedartown, GA
• Providers in Cedartown, GA by specialty
• Optometrist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.