Individual provider Active NPI

Sean Stephen Carr, OD

  • Optometrist
  • Newnan, GA
National Provider Identifier
1669517132
Registry record updated Sep 19, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1601 Issued in GA
Practice address
20 Baker Rd
Ste 5
Newnan, GA 30265-2134
Phone
(770) 254-9997
Fax
(770) 254-0134
NPI assigned
Feb 21, 2007
Last updated
Sep 19, 2011By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 19, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1601 GA Primary

Addresses

Primary practice location

20 Baker Rd
Ste 5
Newnan, GA 30265-2134

Mailing address

481 Grant St SE
Atlanta, GA 30312-3154
Phone (404) 944-9245

Other identifiers 1

IdentifierTypeStateIssuer
DF4499OtherGAMEDICARE ID

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
I20050922000030 GA Practitioner - Optometry 2466486279 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1601GAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Sean Carr OD, PC. Optometrist CurrentSince Jan 1, 2001 Accepting new patients
Sean Carr, O.D., P.C. Optometrist CurrentSince Jan 1, 2001 Accepting new patients

Locations

114 Bullsboro Dr
Newnan, GA 30263
Phone (770) 254-9996

20 Baker Rd
Ste 5
Newnan, GA 30265
Phone (770) 254-9997

8 Bullsboro Dr
Newnan, GA 30263
Phone (770) 254-9996

Organizations & group practices 3

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": "1172016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1316390400000",
    "number": "1669517132",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "481 GRANT ST SE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303123154",
            "telephone_number": "404-944-9245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 BAKER RD",
            "address_2": "STE 5",
            "city": "NEWNAN",
            "state": "GA",
            "postal_code": "302652134",
            "telephone_number": "770-254-9997",
            "fax_number": "770-254-0134"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARR",
        "first_name": "SEAN",
        "middle_name": "STEPHEN",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-21",
        "last_updated": "2011-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "GA",
            "license": "1601",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID",
            "identifier": "DF4499",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Newnan, GA

Sources for this page

Verify at the official NPI Registry.