Active NPI
Kyle Jones, OD
- Optometrist
- Douglasville, GA
National Provider Identifier
1770673790
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- T-001749
- Practice address
- 9412 Parkwood Ave
Douglasville, GA 30135 - Phone
- (770) 938-9030
- NPI assigned
- Oct 13, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | T-001749 | GA | Primary |
Addresses
Primary practice location
9412 Parkwood Ave
Douglasville, GA 30135
Mailing address
4135 Lavista Road
100
Tucker, GA 30084
Phone (770) 939-8840
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| T-001749 | GA | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sheila Gowdy OD PC | Optometrist | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Optometrist
- Douglasville, GA
- NPI 1174786214
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160697600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1188172800000",
"number": "1770673790",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4135 LAVISTA ROAD",
"address_2": "100",
"city": "TUCKER",
"state": "GA",
"postal_code": "30084",
"telephone_number": "770-939-8840"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9412 PARKWOOD AVE",
"city": "DOUGLASVILLE",
"state": "GA",
"postal_code": "30135",
"telephone_number": "770-938-9030"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JONES",
"first_name": "KYLE",
"name_prefix": "Dr.",
"credential": "OD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-10-13",
"last_updated": "2007-08-27",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "GA",
"license": "T-001749",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Douglasville, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.