Individual provider Active NPI

Kathryn Cotter, OD

  • Optometrist
  • Douglasville, GA
National Provider Identifier
1639961600
Registry record updated May 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT003645 Issued in GA
Practice address
1270 Arbor Place Mall
Douglasville, GA 30135-7105
Phone
(770) 942-9827
NPI assigned
May 19, 2025
Last updated
May 19, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 19, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPT003645 GA Primary

Addresses

Primary practice location

1270 Arbor Place Mall
Douglasville, GA 30135-7105

Mailing address

590 Coalville Dr
Lawrenceville, GA 30046-9363
Phone (910) 617-2921

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
I20250612002937 GA Practitioner - Optometry 1759892284 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Infocus Eye Care, IncGroup PAC ID 0345594362, 5 clinicians

Practice addresses (Care Compare)

1270 Arbor Place Mall
Douglasville, GA 30135-7105
Phone (770) 942-9827

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPT003645GAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Infocus Eye Care, Inc. Optometrist CurrentSince May 21, 2025 Accepting new patients

Locations

6700 Douglas Blvd
Ste 1270
Douglasville, GA 30135
Phone (770) 577-4434

3600 Marketplace Blvd
Ste 310
East Point, GA 30344
Phone (404) 346-2020

915 Ridgewalk Pkwy
Ste 425
Woodstock, GA 30188
Phone (770) 517-4414

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1747612800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747612800000",
    "number": "1639961600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "590 COALVILLE DR",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300469363",
            "telephone_number": "910-617-2921"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1270 ARBOR PLACE MALL",
            "city": "DOUGLASVILLE",
            "state": "GA",
            "postal_code": "301357105",
            "telephone_number": "770-942-9827"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COTTER",
        "first_name": "KATHRYN",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-05-19",
        "last_updated": "2025-05-19",
        "certification_date": "2025-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "GA",
            "license": "OPT003645",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Douglasville, GA

Sources for this page

Verify at the official NPI Registry.