Wolf Creek ENT LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

WOLF CREEK ENT LLC

Doing business as

CATHY'S EYE CARE

Practice address

1841 N Columbia St
Milledgeville, GA 31061-2382

Phone

(478) 452-3593

Fax

(478) 936-9992

NPI assigned

May 11, 2007

Organization subpart

No

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

Authorized official

Name

Robin Stewart Frazier

Title

Bookkeeper

Phone

(478) 986-6983

Specialties & licenses 3

Addresses

Other identifiers 4

Other names 1

• CATHY'S EYE CARE Doing business as

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Cathy L Dixon, LDO

  • Optician
  • Milledgeville, GA
  • NPI 1710049168
  NPD (past)
• James T Havens, OD

  • Optometrist
  • Milledgeville, GA
  • NPI 1417019720
  NPD (past)

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

{
    "created_epoch": "1178841600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1210636800000",
    "number": "1700091980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1841 N COLUMBIA ST",
            "city": "MILLEDGEVILLE",
            "state": "GA",
            "postal_code": "310612382",
            "telephone_number": "478-452-3593",
            "fax_number": "478-936-9992"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1841 N COLUMBIA ST",
            "city": "MILLEDGEVILLE",
            "state": "GA",
            "postal_code": "310612382",
            "telephone_number": "478-452-3593",
            "fax_number": "478-936-9992"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WOLF CREEK ENT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-11",
        "last_updated": "2008-05-13",
        "status": "A",
        "authorized_official_last_name": "FRAZIER",
        "authorized_official_first_name": "ROBIN",
        "authorized_official_middle_name": "STEWART",
        "authorized_official_title_or_position": "BOOKKEEPER",
        "authorized_official_telephone_number": "478-986-6983"
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Technician/Technologist, Optician",
            "state": "GA",
            "license": "LDO001648",
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "GA",
            "license": null,
            "primary": true
        },
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SPECTERA",
            "identifier": "07820",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AVESIS MCAID",
            "identifier": "100921",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00897487A",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AVESIS",
            "identifier": "25391",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CATHY'S EYE CARE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Willis Reid Roberts, Jr.
• William A Willoughby, M.D.
• James A Wilson, MD
• Joseph Daniel Wilson, ATC; LAT
• Porter Hamilton Wimberly
• Patricia Joann Wolf, LCSW
• Marina Womack, BCBA
• Michael Demetrice Womble, LPC
• Allyson Courtney Wood, M.P.T.
• Elizabeth T Wood, LPC

• Durable Medical Equipment & Medical Supplies in Milledgeville, GA
• Providers in Milledgeville, GA by specialty
• Durable Medical Equipment & Medical Supplies in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.