Maggie Mooo LLC

Primary specialty

Corneal and Contact Management OptometristTaxonomy code 152WC0802X

Legal business name

MAGGIE MOOO LLC

Practice address

9700 Medlock Bridge Rd Ste 120B
Johns Creek, GA 30097-4408

Phone

(770) 558-1850

Fax

(678) 691-8056

NPI assigned

Aug 28, 2021

Organization subpart

No

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

Authorized official

Name

Dr. Brian Schultz, ODNPI 1467563924

Title

Optometrist/Owner

Phone

(248) 320-8059

Specialties & licenses 1

Addresses

Other names 1

• Uptown Eye Boutique Doing business as

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Brian Schultz, O.D.

  • Optometrist
  • Johns Creek, GA
  • NPI 1467563924
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1630108800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1638057600000",
    "number": "1679240402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9700 MEDLOCK BRIDGE RD STE 120B",
            "city": "JOHNS CREEK",
            "state": "GA",
            "postal_code": "300974408",
            "telephone_number": "248-320-8059"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9700 MEDLOCK BRIDGE RD STE 120B",
            "city": "JOHNS CREEK",
            "state": "GA",
            "postal_code": "300974408",
            "telephone_number": "770-558-1850",
            "fax_number": "678-691-8056"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAGGIE MOOO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-28",
        "last_updated": "2021-11-28",
        "certification_date": "2021-11-28",
        "status": "A",
        "authorized_official_last_name": "SCHULTZ",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_title_or_position": "OPTOMETRIST/OWNER",
        "authorized_official_telephone_number": "248-320-8059",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152WC0802X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Uptown Eye Boutique",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Uptown Eye Boutique",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Charles Albert Machemehl III, DMD, MSD
• Neil S Mackay, PA-C
• Kelly Macphaul, PA-C
• Melissa Presswood Maddux, NP-C
• Ivana Magallanes
• Nelliah Mahachi
• Anuj Dinesh Mahajan, M.D.
• Heather Mainard, LPC
• Melinda K. Maitland, M.ED.
• Ronnie Mak, OD

• Corneal and Contact Management Optometrist in Johns Creek, GA
• Providers in Johns Creek, GA by specialty
• Corneal and Contact Management Optometrist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.