Individual provider Active NPI

Page Jian

  • Optometrist
  • Snellville, GA
National Provider Identifier
1720550312
Registry record updated Dec 20, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT003136 Issued in GA
Practice address
1679 Scenic Hwy N Ste 203
Snellville, GA 30078-2131
Phone
(470) 415-5706
NPI assigned
Dec 20, 2018
Last updated
Dec 20, 2018By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 20, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPT003136 GA Primary

Addresses

Primary practice location

1679 Scenic Hwy N Ste 203
Snellville, GA 30078-2131

Mailing address

530 Stedford LN
Duluth, GA 30097-8007

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20240117000363 GA Practitioner - Optometry 3779935614 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Ga Doctors of Optometry LLC Optometrist CurrentSince Dec 14, 2023 Accepting new patients
Ga Doctors of Optometry LLC Optometrist CurrentSince Dec 14, 2023 Accepting new patients
National Vision, Inc. Single Specialty Past Accepting new patients

Locations

50 Main Street Market Pl SE
Ste 100
Cartersville, GA 30121
Phone (770) 382-6379

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1545264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1545264000000",
    "number": "1720550312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "530 STEDFORD LN",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "300978007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1679 SCENIC HWY N STE 203",
            "city": "SNELLVILLE",
            "state": "GA",
            "postal_code": "300782131",
            "telephone_number": "470-415-5706"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JIAN",
        "first_name": "PAGE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-12-20",
        "last_updated": "2018-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "GA",
            "license": "OPT003136",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Snellville, GA

Sources for this page

Verify at the official NPI Registry.