NPIMap

Organization Active NPI

Jing Dong MD PC

Doing business as Georgia Center for Sight

  • Ophthalmology Physician
  • Elberton, GA
National Provider Identifier
1649681768
Registry record updated Feb 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
045447 Issued in GA
Legal business name
JING DONG MD PC
Doing business as
Georgia Center for Sight
Practice address
5 S McIntosh St
Elberton, GA 30635-2465
Phone
(706) 283-7510
Fax
(706) 283-7570
NPI assigned
May 12, 2014
Reactivated
Jul 3, 2019
Last updated
Feb 28, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2023

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

Authorized official

Name
Candice B Davis
Title
Chief Revenue Cycle Officer
Phone
(916) 990-7590

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPT002405 GA
Optometrist 152W00000X OPT002596 GA
Ophthalmology Physician 207W00000X 045447 GA Primary

Addresses

Primary practice location

5 S McIntosh St
Elberton, GA 30635-2465

Mailing address

5 South McIntosh Street
Elberton, GA 30635
Phone (706) 546-9290

Other identifiers 1

IdentifierTypeStateIssuer
000791568JMedicaidGA

Other names 1

  • Georgia Center for Sight Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1399852800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1677542400000",
    "number": "1649681768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 SOUTH MCINTOSH STREET",
            "city": "ELBERTON",
            "state": "GA",
            "postal_code": "30635",
            "telephone_number": "706-546-9290",
            "fax_number": "706-546-4938"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 S MCINTOSH ST",
            "city": "ELBERTON",
            "state": "GA",
            "postal_code": "306352465",
            "telephone_number": "706-283-7510",
            "fax_number": "706-283-7570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JING DONG MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-05-12",
        "last_updated": "2023-02-28",
        "certification_date": "2023-02-28",
        "deactivation_date": "2019-06-11",
        "reactivation_date": "2019-07-03",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "CANDICE",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "CHIEF REVENUE CYCLE OFFICER",
        "authorized_official_telephone_number": "916-990-7590"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "GA",
            "license": "OPT002405",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "GA",
            "license": "OPT002596",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "GA",
            "license": "045447",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000791568J",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Georgia Center for Sight",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Georgia Center for Sight",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Elberton, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.