Individual provider Active NPI

Seborah Williams King, O.D.

  • Optometrist
  • Macon, GA
National Provider Identifier
1649372343
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT001942 Issued in GA
Practice address
5955 Zebulon Rd
Wal-Mart Vision Center
Macon, GA 31210-2030
Phone
(478) 477-9011
Fax
(478) 471-9042
NPI assigned
Sep 2, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPT001942 GA Primary

Addresses

Primary practice location

5955 Zebulon Rd
Wal-Mart Vision Center
Macon, GA 31210-2030

Mailing address

1005 Underwood Dr
Macon, GA 31210-3332
Phone (478) 737-6286

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
I20110922000791 GA Practitioner - Optometry 2163690843 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPT001942GAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Ga Doctors of Optometry LLC Optometrist CurrentSince Oct 17, 2021 Accepting new patients
Ga Doctors of Optometry LLC Optometrist CurrentSince Oct 17, 2021 Accepting new patients
Mark Lynn O.D. & Associates, PC CurrentSince Sep 8, 2014 Accepting new patients
New Vision Family Eye Care Center, L.L.C. Optometrist CurrentSince Jun 1, 2011 Accepting new patients
Mark Lynn OD & Associates, PC Optometrist CurrentSince Sep 8, 2014 Accepting new patients
Seborah W. King, O.D. & Associates, L.L.C. Optometrist Past Accepting new patients
King Family Eye Care,LLC Optometrist Past Accepting new patients

Locations

50 Main Street Market Pl SE
Ste 100
Cartersville, GA 30121
Phone (770) 382-6379

2929 Turner Hill Rd
Ste 2625
Lithonia, GA 30038
Phone (770) 482-5050

3711 Eisenhower Pkwy
Macon, GA 31206
Phone (478) 476-8108

5080 Riverside Dr
Ste 326
Macon, GA 31210
Phone (478) 477-0323

Organizations & group practices 7

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": "1157155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1649372343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1005 UNDERWOOD DR",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312103332",
            "telephone_number": "478-737-6286",
            "fax_number": "478-477-9149"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5955 ZEBULON RD",
            "address_2": "WAL-MART VISION CENTER",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312102030",
            "telephone_number": "478-477-9011",
            "fax_number": "478-471-9042"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KING",
        "first_name": "SEBORAH",
        "middle_name": "WILLIAMS",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "GA",
            "license": "OPT001942",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Macon, GA

Sources for this page

Verify at the official NPI Registry.