Marisha Spence-Roberts, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPT002698 Issued in GA

Practice address

2124 Candler Road
Jencare Neighborhood Medical Center South Dekalb, LLC
Decatur, GA 30032-5500

Phone

(404) 836-0272

Fax

(404) 420-2445

NPI assigned

Jul 23, 2012

Last updated

Mar 10, 2016By the provider in NPPES

Sex

Female

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

State licenses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• The Family Health Centers of Georgia, Inc

  dba The Family Health Center at West End

  • Federally Qualified Health Center (FQHC)
  • Atlanta, GA
  • NPI 1720080989
  Medicare reassignment NPD
• The Family Health Centers of Georgia, Inc

  dba The Family Health Center@ Bolton Village

  • Federally Qualified Health Center (FQHC)
  • Atlanta, GA
  • NPI 1760612055
  NPD
• The Family Health Centers of Georgia, Inc

  dba McDonough Children's Specialist

  • Federally Qualified Health Center (FQHC)
  • McDonough, GA
  • NPI 1982489555
  NPD
• PMR Georgia Holding, LLC

  dba Jencare Neighborhood Medical Center

  • Specialist
  • Miami Gardens, FL
  • NPI 1609329630
  NPD

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

{
    "created_epoch": "1343001600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1457568000000",
    "number": "1790030096",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "868 YORK AVE SW",
            "address_2": "JENCARE NEIGHBORHOOD MEDICAL CENTER SOUTH DEKALB, LLC",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303102750",
            "telephone_number": "404-752-1400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2124 CANDLER ROAD",
            "address_2": "JENCARE NEIGHBORHOOD MEDICAL CENTER SOUTH DEKALB, LLC",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300325500",
            "telephone_number": "404-836-0272",
            "fax_number": "404-420-2445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPENCE-ROBERTS",
        "first_name": "MARISHA",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-23",
        "last_updated": "2016-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "GA",
            "license": "OPT002698",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Spectrum Community Care LLC
• Spectrum Health Services
• Speech Glam Speech and Language Services, LLC
• Speech Therepeze, Inc. (Progressive Therapy)
• Hanna Karleigh Speer
• Roy A Spence, PAAA
• Brittany Spencer
• Wade L Spencer
• David Patrick Speno, MDIV.
• Kris Lee Sperry, M. D.

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2016; 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.