NPIMap

Organization Active NPI

Professional Eye Associates, Inc.

  • Ophthalmology Physician
  • Dalton, GA
National Provider Identifier
1699777862
Registry record updated Dec 5, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
20021215 Issued in GA
Legal business name
PROFESSIONAL EYE ASSOCIATES, INC.
Practice address
1111 Professional Blvd
Dalton, GA 30720-2588
Phone
(706) 226-2020
Fax
(706) 217-2876
NPI assigned
Jun 1, 2005
Last updated
Dec 5, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2008

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

Authorized official

Name
Mrs. Sandra D Curd
Title
Coo
Phone
(706) 226-2020

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 20021215 GA Primary

Addresses

Primary practice location

1111 Professional Blvd
Dalton, GA 30720-2588

Mailing address

1111 Professional Blvd
Dalton, GA 30720-2588
Phone (706) 226-2020

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040611000157 GA Part B Supplier - Clinic/Group Practice 4789677071 Receives reassigned benefits from 8 practitioners
Practice locations: Calhoun, GA; Dalton, GA; Ft Oglethorpe, GA

Other NPIs with the same Medicare PAC ID 5

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Professional Eye Assoc6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

Locations

113 W Pine St
Chatsworth, GA 30705
Phone (706) 226-2020

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1117584000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1228435200000",
    "number": "1699777862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 PROFESSIONAL BLVD",
            "city": "DALTON",
            "state": "GA",
            "postal_code": "307202588",
            "telephone_number": "706-226-2020",
            "fax_number": "706-217-2876"
        },
        {
            "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",
            "fax_number": "706-217-2876"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROFESSIONAL EYE ASSOCIATES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-01",
        "last_updated": "2008-12-05",
        "status": "A",
        "authorized_official_last_name": "CURD",
        "authorized_official_first_name": "SANDRA",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "706-226-2020",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "GA",
            "license": "20021215",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dalton, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2008; 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.