Active NPI
Eye Care Centers Management Inc
- Ophthalmology Physician
- Morrow, GA
National Provider Identifier
1699888131
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ophthalmology Physician
- Legal business name
- EYE CARE CENTERS MANAGEMENT INC
- Practice address
- 1000 Corporate Center Dr
Ste 100
Morrow, GA 30260-4180 - Phone
- (770) 968-8888
- Fax
- (770) 960-2473
- NPI assigned
- Aug 17, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Joon Y Kim, MD
- Title
- Owner
- Phone
- (770) 968-8888
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | |||
| Ophthalmology Physician | 207W00000X | Primary | ||
| Eyewear Supplier | 332H00000X | 016040001 | GA |
Addresses
Primary practice location
1000 Corporate Center Dr
Ste 100
Morrow, GA 30260-4180
Mailing address
1000 Corporate Center Dr
Ste 100
Morrow, GA 30260-4180
Phone (770) 968-8888
Other practice location 1
500 Plaza Pkwy
McDonough, GA 30253-6146
Phone (770) 968-8888
Other practice location 2
620A S 8th St
Griffin, GA 30224-4214
Phone (770) 968-8888
Other practice location 3
60 Oak Hill Blvd
Newnan, GA 30265-2314
Phone (770) 968-8888
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| C16012 | Other | GA | RAILROAD MEDICARE |
| 300027085A | Medicaid | GA |
Other names 1
- Clayton Eye Center or Spalding Eye Center
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in GA
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040422000201 | GA | Part B Supplier - Clinic/Group Practice | 5092701342 |
Receives reassigned benefits from 13 practitioners 1 other NPI on this enrollment Practice locations: McDonough, GA; Morrow, GA; Newnan, GA |
| O20100930057084 | GA | DME Supplier - Physician - Optometrist | 5092701342 | Practice locations: Morrow, GA |
Other NPIs on the same Medicare enrollment 1
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
National Provider Directory
National Provider Directory- Tax ID family
- Eye Care Centers Manag
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Eyewear Supplier
- Morrow, GA
- NPI 1316094576
Locations
620 S 8th St
Ste A
Griffin, GA 30224
1000 Corporate Center Dr
Ste 100
Morrow, GA 30260
Phone (770) 968-8888
1000 Corporate Center Dr
Ste 120
Morrow, GA 30260
1000 Corporate Center Dr
Ste 180
Morrow, GA 30260
Phone (770) 968-8888
60 Oak Hill Blvd
Newnan, GA 30265
Phone (770) 683-8637
Interoperability endpoints
- bfrantz@cec.intellechartdirect.net
- hlattouf@cec.intellechartdirect.net
- arobateau@cec.intellechartdirect.net
- ckim@cec.intellechartdirect.net
- ldubiner@cec.intellechartdirect.net
- rwoodruff@cec.intellechartdirect.net
- egarcia@cec.intellechartdirect.net
- apetty@cec.intellechartdirect.net
- mthai@cec.intellechartdirect.net
Practitioners & affiliated clinicians
Practitioners 18
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155772800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1617148800000",
"number": "1699888131",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1000 CORPORATE CENTER DR",
"address_2": "STE 100",
"city": "MORROW",
"state": "GA",
"postal_code": "302604180",
"telephone_number": "770-968-8888",
"fax_number": "770-960-2473"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1000 CORPORATE CENTER DR",
"address_2": "STE 100",
"city": "MORROW",
"state": "GA",
"postal_code": "302604180",
"telephone_number": "770-968-8888",
"fax_number": "770-960-2473"
}
],
"practiceLocations": [
{
"address_1": "500 Plaza Pkwy",
"address_purpose": "LOCATION",
"city": "McDonough",
"state": "GA",
"postal_code": "302536146",
"country_code": "US",
"telephone_number": "770-968-8888",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "620A S 8th St",
"address_purpose": "LOCATION",
"city": "Griffin",
"state": "GA",
"postal_code": "302244214",
"country_code": "US",
"telephone_number": "770-968-8888",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "60 Oak Hill Blvd",
"address_purpose": "LOCATION",
"city": "Newnan",
"state": "GA",
"postal_code": "302652314",
"country_code": "US",
"telephone_number": "770-968-8888",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"organization_name": "EYE CARE CENTERS MANAGEMENT INC",
"organizational_subpart": "NO",
"enumeration_date": "2006-08-17",
"last_updated": "2021-03-31",
"certification_date": "2021-03-31",
"status": "A",
"authorized_official_last_name": "KIM",
"authorized_official_first_name": "JOON",
"authorized_official_middle_name": "Y",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "770-968-8888",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Optometrist",
"state": null,
"license": null,
"primary": false
},
{
"code": "207W00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Ophthalmology",
"state": null,
"license": null,
"primary": true
},
{
"code": "332H00000X",
"taxonomy_group": "",
"desc": "Eyewear Supplier",
"state": "GA",
"license": "016040001",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "C16012",
"state": "GA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "300027085A",
"state": "GA"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Clayton Eye Center or Spalding Eye Center",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Clayton Eye Center or Spalding Eye Center",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Morrow, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 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.