Organization Active NPI

Allatoona Eye Institute PC

Doing business as Allatoona Eye Clinic

  • Ophthalmology Physician
  • Cartersville, GA
National Provider Identifier
1740338185
Registry record updated May 13, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
ALLATOONA EYE INSTITUTE PC
Doing business as
Allatoona Eye Clinic
Practice address
962 Joe Frank Harris Pkwy SE
Suite 201
Cartersville, GA 30120-2154
Phone
(770) 382-3598
NPI assigned
Jan 8, 2007
Last updated
May 13, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 13, 2008

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

Authorized official

Name
Kim Smith
Title
Administrator
Phone
(770) 382-3598

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X NU Primary

Addresses

Primary practice location

962 Joe Frank Harris Pkwy SE
Suite 201
Cartersville, GA 30120-2154

Mailing address

962 Joe Frank Harris Pkwy SE
Suite 201
Cartersville, GA 30120-2154
Phone (770) 382-3598

Other names 1

  • Allatoona Eye Clinic Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040325000354 GA Part B Supplier - Clinic/Group Practice 2062304231 Receives reassigned benefits from 3 practitioners
Practice locations: Cartersville, GA
O20100930097046 GA DME Supplier - Physician - Ophthalmology 2062304231 Practice locations: Cartersville, GA

National Provider Directory

National Provider Directory

Locations

962 Joe Frank Harris Pkwy SE
Ste 201
Cartersville, GA 30120
Phone (770) 382-3598

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1168214400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1210636800000",
    "number": "1740338185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "962 JOE FRANK HARRIS PKWY SE",
            "address_2": "SUITE 201",
            "city": "CARTERSVILLE",
            "state": "GA",
            "postal_code": "301202154",
            "telephone_number": "770-382-3598"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "962 JOE FRANK HARRIS PKWY SE",
            "address_2": "SUITE 201",
            "city": "CARTERSVILLE",
            "state": "GA",
            "postal_code": "301202154",
            "telephone_number": "770-382-3598"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALLATOONA EYE INSTITUTE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-08",
        "last_updated": "2008-05-13",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "KIM",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "770-382-3598"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Allatoona Eye Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Cartersville, GA

Sources for this page

  • 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.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.