Gayle Kornman, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPT001217 Issued in GA

Practice address

1418 Dresden Dr NE
Brookhaven, GA 30319-3598

Phone

(404) 239-0272

Fax

(404) 239-0298

NPI assigned

Dec 19, 2006

Last updated

Jan 28, 2016By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Family Eye Care, Inc.

  • Optometrist
  • Worcester, MA
  • NPI 1073674446
  NPD (past)
• Family Eye Care, Inc.

  • Optometrist
  • Spencer, MA
  • NPI 1245652866
  NPD (past)

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

{
    "created_epoch": "1166486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1453939200000",
    "number": "1720141757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1950 OLD GALLOWS RD",
            "address_2": "SUITE 520",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221823990",
            "telephone_number": "703-847-8899",
            "fax_number": "703-991-0514"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1418 DRESDEN DR NE",
            "city": "BROOKHAVEN",
            "state": "GA",
            "postal_code": "303193598",
            "telephone_number": "404-239-0272",
            "fax_number": "404-239-0298"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KORNMAN",
        "first_name": "GAYLE",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-19",
        "last_updated": "2016-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MA",
            "license": "3435",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "GA",
            "license": "OPT001217",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Susan Kirsch, M.D.
• Kevin A Kissoon, PA
• Sonya Lynne Klein, MSN, APRN, PMHNP-BC
• Katherine Dru Klinger
• Samantha Knight, DMD
• Karyn Korsah
• Amanda Kriegel, PSYD
• Sameh Akhnoukh Labib, MD
• Shannon Lamar, CCC-SLP
• Caroline Landers, CCC-SLP

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2016; 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.