NPIMap

Organization Active NPI

Marietta Eye Optical Inc

  • Ophthalmology Physician
  • Suwanee, GA
National Provider Identifier
1780572933
Registry record updated Jun 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
MARIETTA EYE OPTICAL INC
Practice address
4025 Johns Creek Pkwy
Suwanee, GA 30024-5682
Phone
(770) 427-8111
NPI assigned
Jun 26, 2025
Last updated
Jun 26, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
MARIETTA EYE OPTICAL INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 26, 2025

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

Authorized official

Name
Rebecca Thackston
Title
Manager
Phone
(770) 427-8111

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X
Ophthalmology Physician 207W00000X Primary

Addresses

Primary practice location

4025 Johns Creek Pkwy
Suwanee, GA 30024-5682

Mailing address

895 Canton Rd NE BLDG 100
Marietta, GA 30060-8935
Phone (770) 427-8111

Other names 1

  • Marietta Eye Optical Johns Creek Other name

National Provider Directory

National Provider Directory
Tax ID family
Marietta Eye Optical8 organizations share this tax ID, including this one
Part of
Marietta Eye Optical

Other organizations with this tax ID 7

Organizations that report the same tax identification number in the National Provider Directory.

Locations

4025 Johns Creek Pkwy
Suwanee, GA 30024
Phone (404) 575-4505

NPI Registry JSON

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

{
    "created_epoch": "1750896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1750896000000",
    "number": "1780572933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "895 CANTON RD NE BLDG 100",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300608935",
            "telephone_number": "770-427-8111",
            "fax_number": "770-499-1643"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4025 JOHNS CREEK PKWY",
            "city": "SUWANEE",
            "state": "GA",
            "postal_code": "300245682",
            "telephone_number": "770-427-8111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARIETTA EYE OPTICAL INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MARIETTA EYE OPTICAL INC",
        "enumeration_date": "2025-06-26",
        "last_updated": "2025-06-26",
        "certification_date": "2025-06-26",
        "status": "A",
        "authorized_official_last_name": "THACKSTON",
        "authorized_official_first_name": "REBECCA",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "770-427-8111"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Marietta Eye Optical Johns Creek",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Suwanee, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.