Individual provider Active NPI

Stella Onyekwelu

  • Optometrist
  • Warner Robins, GA
National Provider Identifier
1679986913
Registry record updated Jun 4, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT002814 Issued in GA
Practice address
502 Booth Rd
(Inside Walmart Vision Center)
Warner Robins, GA 31088-3422
Phone
(478) 918-0636
Fax
(478) 918-0683
NPI assigned
Jun 4, 2014
Last updated
Jun 4, 2014By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 4, 2014

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPT002814 GA Primary
Corneal and Contact Management Optometrist 152WC0802X OPT002814 GA
Pediatric Optometrist 152WP0200X OPT002814 GA
Vision Therapy Optometrist 152WV0400X OPT002814 GA

Addresses

Primary practice location

502 Booth Rd
(Inside Walmart Vision Center)
Warner Robins, GA 31088-3422

Mailing address

86 Westcliff Cir
Warner Robins, GA 31093-8899
Phone (618) 741-3715

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
I20140811002811 GA Practitioner - Optometry 6901023142 Reassigns benefits to 2 organizations
Practice locations: Warner Robins, GA

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

502 Booth Rd
Warner Robins, GA 31088-3422
Phone (478) 918-0636

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPT002814GAMDVision Therapy Optometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Ga Doctors of Optometry LLC Optometrist CurrentSince Oct 17, 2021 Accepting new patients
Ga Doctors of Optometry LLC Optometrist CurrentSince Oct 17, 2021 Accepting new patients
Mark Lynn OD & Associates, PC Optometrist CurrentSince Oct 16, 2014 Accepting new patients
Mark Lynn O.D. & Associates, PC CurrentSince Oct 16, 2014 Accepting new patients
Stella Onyekwelu, OD Optometrist PastSince Jun 4, 2014 Accepting new patients
Dr. Daniel D. Gottlieb Optometrist, PC PastSince Oct 30, 2017 Accepting new patients

Locations

3333 Buford Dr
Ste 1030
Buford, GA 30519
Phone (678) 546-0024

50 Main Street Market Pl SE
Ste 100
Cartersville, GA 30121
Phone (770) 382-6379

2929 Turner Hill Rd
Ste 2625
Lithonia, GA 30038
Phone (770) 482-5050

Organizations & group practices 6

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": "1401840000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1401840000000",
    "number": "1679986913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "86 WESTCLIFF CIR",
            "city": "WARNER ROBINS",
            "state": "GA",
            "postal_code": "310938899",
            "telephone_number": "618-741-3715"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "502 BOOTH RD",
            "address_2": "(INSIDE WALMART VISION CENTER)",
            "city": "WARNER ROBINS",
            "state": "GA",
            "postal_code": "310883422",
            "telephone_number": "478-918-0636",
            "fax_number": "478-918-0683"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ONYEKWELU",
        "first_name": "STELLA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-06-04",
        "last_updated": "2014-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "GA",
            "license": "OPT002814",
            "primary": true
        },
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "GA",
            "license": "OPT002814",
            "primary": false
        },
        {
            "code": "152WP0200X",
            "taxonomy_group": "",
            "desc": "Optometrist, Pediatrics",
            "state": "GA",
            "license": "OPT002814",
            "primary": false
        },
        {
            "code": "152WV0400X",
            "taxonomy_group": "",
            "desc": "Optometrist, Vision Therapy",
            "state": "GA",
            "license": "OPT002814",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Warner Robins, GA

Sources for this page

Verify at the official NPI Registry.