Individual provider Active NPI

William C Bonner, OD

  • Optometrist
  • Cumming, GA
National Provider Identifier
1750309597
Registry record updated Jan 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT001133 Issued in GA
Practice address
1034 Haw Creek Cir Ste 100
Cumming, GA 30041-6513
Phone
(678) 737-4616
NPI assigned
Jul 18, 2006
Last updated
Jan 12, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPT001133 GA Primary

Addresses

Primary practice location

1034 Haw Creek Cir Ste 100
Cumming, GA 30041-6513

Mailing address

9875 Medlock Bridge Pkwy Ste 100
Johns Creek, GA 30022-6640
Phone (770) 813-0026

Other practice location 1

9875 Medlock Bridge Pkwy Ste 100
Johns Creek, GA 30022-6640
Phone (770) 813-0026 ext. 122

Other practice location 2

73 Prestige Ln Ste 201
Dawsonville, GA 30534-6371
Phone (064) 712-4377

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
I20101213000235 GA Practitioner - Optometry 3971790213 Reassigns benefits to 1 organization
Practice locations: Jasper, GA; Rome, GA

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of Houston - College of Optometry, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Milan Eye LLCGroup PAC ID 2668519109, 21 clinicians

Practice addresses (Care Compare)

73 Prestige LN
Suite 201
Dawsonville, GA 30534-6371
Phone (678) 381-2020

Merit-based Incentive Payment System (MIPS)

Final score
84.14 of 100Reported as group
Quality
94
Promoting interoperability
71
Improvement activities
40
Cost
77.3

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1133GAMDRehabilitation Chiropractor
OPT001133GAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Milan Eye LLC CurrentSince Dec 12, 2022 Accepting new patients
Alpharetta Eye Surgery Center LLC Past Accepting new patients
Marietta Vision Past Accepting new patients
Buford Eye Surgery Center Past Accepting new patients

Locations

201 Kimberly Way
Ste 200
Canton, GA 30114

73 Prestige Ln
Ste 201
Dawsonville, GA 30534

Organizations & group practices 4

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": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673481600000",
    "number": "1750309597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9875 MEDLOCK BRIDGE PKWY STE 100",
            "city": "JOHNS CREEK",
            "state": "GA",
            "postal_code": "300226640",
            "telephone_number": "770-813-0026",
            "fax_number": "770-813-0029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1034 HAW CREEK CIR STE 100",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300416513",
            "telephone_number": "678-737-4616"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9875 Medlock Bridge Pkwy Ste 100",
            "address_purpose": "LOCATION",
            "city": "Johns Creek",
            "state": "GA",
            "postal_code": "300226640",
            "country_code": "US",
            "telephone_number": "770-813-0026 x122",
            "fax_number": "770-813-0029",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "73 Prestige Ln Ste 201",
            "address_purpose": "LOCATION",
            "city": "Dawsonville",
            "state": "GA",
            "postal_code": "305346371",
            "country_code": "US",
            "telephone_number": "064-712-4377",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BONNER",
        "first_name": "WILLIAM",
        "middle_name": "C",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-18",
        "last_updated": "2023-01-12",
        "certification_date": "2023-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "GA",
            "license": "OPT001133",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cumming, GA

Sources for this page

Verify at the official NPI Registry.