Individual provider Active NPI

Linda Mewis Christmann, MD

  • Ophthalmology Physician
  • Atlanta, GA
National Provider Identifier
1659550093
Registry record updated Jun 12, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
2007-01550 Issued in NC
Practice address
3495 Piedmont Road, NE, BLDG. 9
The Southeast Permanente Medical Group, Inc.
Atlanta, GA 30305
Phone
(404) 364-4272
Fax
(318) 448-4903
NPI assigned
Nov 2, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 2007-01550 NC Primary

Addresses

Primary practice location

3495 Piedmont Road, NE, BLDG. 9
The Southeast Permanente Medical Group, Inc.
Atlanta, GA 30305

Mailing address

5308 Fairfield Blvd
Bradenton, FL 34203-8028
Phone (252) 218-2996

Other identifiers 1

IdentifierTypeStateIssuer
DM0772MedicaidSC

Other names 1

  • Linda Mewis Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
14071SCMDPharmacist
2007-01550NCMDOphthalmology Physician

NPI Registry JSON

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

{
    "created_epoch": "1193961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1497225600000",
    "number": "1659550093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5308 FAIRFIELD BLVD",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342038028",
            "telephone_number": "252-218-2996",
            "fax_number": "318-448-4903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3495 PIEDMONT ROAD, NE, BLDG. 9",
            "address_2": "THE SOUTHEAST PERMANENTE MEDICAL GROUP, INC.",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "30305",
            "telephone_number": "404-364-4272",
            "fax_number": "318-448-4903"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHRISTMANN",
        "first_name": "LINDA",
        "middle_name": "MEWIS",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-11-02",
        "last_updated": "2017-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NC",
            "license": "2007-01550",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "DM0772",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LINDA",
            "last_name": "MEWIS",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2017; 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.