Upson Eye Clinic

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

048999 Issued in GA

Legal business name

UPSON EYE CLINIC

Practice address

232 Cherokee Rd
Thomaston, GA 30286-3402

Phone

(706) 647-8138

Fax

(706) 647-8745

NPI assigned

Nov 21, 2007

Last updated

May 7, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Stephanie N Bradley

Title

Billing

Phone

(706) 647-8138

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Kenneth Murray Deen, MD

  • Ophthalmology Physician
  • Thomaston, GA
  • NPI 1841301900
  Medicare reassignment
• Johnny T Deen, MD

  • Ophthalmology Physician
  • Thomaston, GA
  • NPI 1134218753
  NPD (past)

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

{
    "created_epoch": "1195603200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1241654400000",
    "number": "1629259395",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "232 CHEROKEE RD",
            "city": "THOMASTON",
            "state": "GA",
            "postal_code": "302863402",
            "telephone_number": "706-647-8138",
            "fax_number": "706-647-8745"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "232 CHEROKEE RD",
            "city": "THOMASTON",
            "state": "GA",
            "postal_code": "302863402",
            "telephone_number": "706-647-8138",
            "fax_number": "706-647-8745"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UPSON EYE CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-21",
        "last_updated": "2009-05-07",
        "status": "A",
        "authorized_official_last_name": "BRADLEY",
        "authorized_official_first_name": "STEPHANIE",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "BILLING",
        "authorized_official_telephone_number": "706-647-8138",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "GA",
            "license": "048999",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CB6575",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000896695A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Upson County Hospital Inc (Upson Regional Medical Center)
• Upson County Hospital Inc (Upson Regional Medical Center)
• Upson County Hospital Inc. (Upson Regional Medical Center)
• Upson County Hospital Inc. (Upson Family Physicians)
• Upson County Hospital Inc. (Upson Family Medical Center)
• Upson Family Medical Center ,LLC
• Upson Family Physicians, LC
• Upson Medical Associates LLC
• Upson Medical Emergency Physicans, LLC
• Upson Orthopaedic Clinic

• Ophthalmology Physician in Thomaston, GA
• Providers in Thomaston, GA by specialty
• Ophthalmology Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.