Jacob Daniel Deweese, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPT003376 Issued in GA

Practice address

2200 Roswell Rd Ste 160
Marietta, GA 30062-2984

Phone

(770) 565-6200

NPI assigned

Oct 12, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Optometry

Education

Indiana University - School of Optometry, 2021

Medicare assignment

May accept Medicare assignment

Group practices

Family First Vision Care GeorgiaGroup PAC ID 3173934981, 8 clinicians

Clarkson Optometry Georgia IncGroup PAC ID 5193732949, 14 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://app.meldrx.com/api/fhir/ecp_cecga

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.

• Clarkson Optometry Georgia Inc

  • Optometrist
  • Alpharetta, GA
  • NPI 1184802670
  Medicare reassignment Care Compare group NPD
• Family First Vision Care Georgia

  • Optometrist
  • Roswell, GA
  • NPI 1649881236
  Medicare reassignment Care Compare group NPD
• Star Optometry Ga LLC

  • Optometrist
  • Cumming, GA
  • NPI 1528944451
  Medicare reassignment NPD
• Family First Vision Care Georgia PLLC

  • Optometrist
  • Canton, GA
  • NPI 1003675893
  NPD (past)
• Family First Vision Care Georgia PLLC

  • Optometrist
  • Cartersville, GA
  • NPI 1174382964
  NPD (past)
• Mobley Eye Care of Sharpsburg

  • Optometrist
  • Sharpsburg, GA
  • NPI 1902145873
  NPD (past)
• Mobley Riverdale Eye Clinic Inc

  • Optometrist
  • Fayetteville, GA
  • NPI 1407027683
  NPD (past)
• State of Mississippi - University of Mississippi Medical Center

  • Critical Access Hospital
  • Lexington, MS
  • NPI 1386630705
  NPD (past)

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

{
    "created_epoch": "1633996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633996800000",
    "number": "1699437129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3699 LENOX RD NE APT G47",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303053489",
            "telephone_number": "317-607-8930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 ROSWELL RD STE 160",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300622984",
            "telephone_number": "770-565-6200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEWEESE",
        "first_name": "JACOB",
        "middle_name": "DANIEL",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-10-12",
        "last_updated": "2021-10-12",
        "certification_date": "2021-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "GA",
            "license": "OPT003376",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amy Desrochers, RN
• Wanda Hazel Devaughn, LCSW
• Devereux Foundation
• Gayathri K Devineni, MD
• Indira Devu, MD
• Susan Ulmer Dewolf, CRNFA, NP-C
• Mary Curran Dewyngaert, PA-AA
• Manpreet Kaur Dhillon, M.D.
• Diabetic Medic,LLC
• Nassaratou Diaby, PMHNP-BC

• Optometrist in Marietta, GA
• Providers in Marietta, GA by specialty
• Optometrist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.