Individual provider Active NPI

Glenda B Brown, OD

  • Optometrist
  • Suwanee, GA
National Provider Identifier
1790897494
Registry record updated Mar 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
001006 Issued in GA
Practice address
1120 Peachtree Industrial Blvd
Ste 101
Suwanee, GA 30024-2013
Phone
(770) 809-3366
Fax
(770) 809-3367
NPI assigned
Aug 31, 2006
Last updated
Mar 8, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 001006 GA Primary

Addresses

Primary practice location

1120 Peachtree Industrial Blvd
Ste 101
Suwanee, GA 30024-2013

Mailing address

1120 Peachtree Industrial Blvd
Ste 101
Suwanee, GA 30024-2013
Phone (770) 809-3366

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address gbbrown@teg.emadirect.md Direct

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
I20120308000140 GA Practitioner - Optometry 5294994430 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Thomas Eye Group PCGroup PAC ID 2567455868, 51 clinicians

Practice addresses (Care Compare)

1120 Peachtree Industrial Blvd
Suwanee, GA 30024-2013
Phone (770) 809-3366

11690 Alpharetta Hwy
Roswell, GA 30076-3805
Phone (770) 475-5515

Merit-based Incentive Payment System (MIPS)

Final score
94.51 of 100Reported as apm
Quality
80.61
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
001006GAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Thomas Eye Group PC Optometrist CurrentSince Jun 10, 2013 Accepting new patients
Thomas Eye Group PC Optometrist Current Accepting new patients
Thomas Eye Group PC Optometrist CurrentSince Jun 10, 2013 Accepting new patients
Thomas Eye Group PC Past Accepting new patients
Payne & Payne, PC Optometrist PastSince Aug 16, 2007 Accepting new patients
Oneopto Ga 1 PLLC Optometrist Past Accepting new patients

Locations

11690 Alpharetta Hwy
Roswell, GA 30076
Phone (770) 475-5515

5995 Barfield Rd
Sandy Springs, GA 30328
Phone (404) 256-1507

1120 Peachtree Industrial Blvd
Ste 101
Suwanee, GA 30024
Phone (770) 809-3366

Interoperability endpoints

  • Direct secure messaging: gbbrown@teg.emadirect.md

Organizations & group practices 6

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": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615161600000",
    "number": "1790897494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1120 PEACHTREE INDUSTRIAL BLVD",
            "address_2": "STE 101",
            "city": "SUWANEE",
            "state": "GA",
            "postal_code": "300242013",
            "telephone_number": "770-809-3366",
            "fax_number": "770-809-3367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1120 PEACHTREE INDUSTRIAL BLVD",
            "address_2": "STE 101",
            "city": "SUWANEE",
            "state": "GA",
            "postal_code": "300242013",
            "telephone_number": "770-809-3366",
            "fax_number": "770-809-3367"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "GLENDA",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-31",
        "last_updated": "2021-03-08",
        "certification_date": "2021-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "GA",
            "license": "001006",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "gbbrown@teg.emadirect.md",
            "affiliation": "N",
            "endpointDescription": "Direct Messaging",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Direct Edge",
            "address_1": "1120 Peachtree Industrial Blvd",
            "address_2": "Ste 101",
            "city": "Suwanee",
            "state": "GA",
            "country_code": "US",
            "postal_code": "300242013",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Suwanee, GA

Sources for this page

Verify at the official NPI Registry.