Individual provider Active NPI

Robi A Wingrove, OD

  • Optometrist
  • Dalton, GA
National Provider Identifier
1679575898
Registry record updated Sep 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1831 Issued in TN
Practice address
1111 Professional Blvd
Dalton, GA 30720-2588
Phone
(706) 226-2020
NPI assigned
Jun 1, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPT001786 GA
Optometrist 152W00000X 1831 TN Primary

Addresses

Primary practice location

1111 Professional Blvd
Dalton, GA 30720-2588

Mailing address

8614 Westwood Center Dr FL 9
Vienna, VA 22182-2442
Phone (703) 847-8899

Other practice location 1

629 Market St Ste 115
Chattanooga, TN 37402-4891
Phone (423) 265-4306

Other identifiers 1

IdentifierTypeStateIssuer
00855522AMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, TN2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20100909000725 GA Practitioner - Optometry 8921123209 Reassigns benefits to 1 organization
I20241121002799 TN Practitioner - Optometry 8921123209 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

629 Market St
Suite 115
Chattanooga, TN 37402-4891
Phone (423) 265-4306

Merit-based Incentive Payment System (MIPS)

Final score
93.41 of 100Reported as group
Quality
100
Improvement activities
40
Cost
78.03

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Professional Eye Associates, Inc. CurrentSince Jan 26, 2000 Accepting new patients
Myeyedr Optometry of Tennessee, LLC Optometrist CurrentSince Sep 17, 2024 Accepting new patients
Myeyedr Optometry of Tennessee, LLC Optometrist CurrentSince Sep 17, 2024 Accepting new patients
Professional Eye Associates, Inc. CurrentSince Jan 26, 2000 Accepting new patients

Locations

1111 Professional Blvd
Dalton, GA 30720
Phone (404) 226-2232

2498 Lafayette Rd
Ft Oglethorpe, GA 30742
Phone (706) 866-2020

629 Market St
Ste 115
Chattanooga, TN 37402
Phone (423) 265-4306

8614 Westwood Center Dr
Fl 9
Vienna, VA 22182

Interoperability endpoints

  • Direct secure messaging: rwingrove033160@myeyedr.emadirect.md

Organizations & group practices 4

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": "1117584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725408000000",
    "number": "1679575898",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8614 WESTWOOD CENTER DR FL 9",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221822442",
            "telephone_number": "703-847-8899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 PROFESSIONAL BLVD",
            "city": "DALTON",
            "state": "GA",
            "postal_code": "307202588",
            "telephone_number": "706-226-2020"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "629 Market St Ste 115",
            "address_purpose": "LOCATION",
            "city": "Chattanooga",
            "state": "TN",
            "postal_code": "374024891",
            "country_code": "US",
            "telephone_number": "423-265-4306",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WINGROVE",
        "first_name": "ROBI",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-01",
        "last_updated": "2024-09-04",
        "certification_date": "2024-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "GA",
            "license": "OPT001786",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TN",
            "license": "1831",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00855522A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dalton, GA

Sources for this page

Verify at the official NPI Registry.