Victor K Thao

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPT003629 Issued in GA

Practice address

1805 Epps Bridge Pkwy Ste 105
Athens, GA 30606-6127

Phone

(706) 352-2282

NPI assigned

May 2, 2024

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Ga Doctors of Optometry LLC

  • Optometrist
  • Lithonia, GA
  • NPI 1174105936
  Medicare reassignment NPD
• Ga Doctors of Optometry LLC

  • Eyewear Supplier
  • Columbus, GA
  • NPI 1013599745

  Optometrist

  NPD

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

{
    "created_epoch": "1714608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734393600000",
    "number": "1740037142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "628 COOPER RIVER CIR UNIT 3310",
            "city": "FORT MILL",
            "state": "SC",
            "postal_code": "297158964",
            "telephone_number": "980-428-4754"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1805 EPPS BRIDGE PKWY STE 105",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "306066127",
            "telephone_number": "706-352-2282"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THAO",
        "first_name": "VICTOR",
        "middle_name": "K",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-05-02",
        "last_updated": "2024-12-17",
        "certification_date": "2024-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "GA",
            "license": "OPT003629",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ronald Lynn Terry, M.D.
• Phyllis A. Tettey-Enyo, NP-C
• Elizabeth Thacker, LPC
• Karan Thakkar
• Chandler Gerald Thames, OD
• Ashwin Thatti
• The Center for Plastic & Reconstructive Surgery, P.C.
• The Fox Club LLC
• The Kroger Co
• The Kroger Co

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.