Organization Active NPI

Boeyink Eyecare PC

  • Optometrist
  • Carrollton, GA
National Provider Identifier
1821132564
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT001547 Issued in GA
Legal business name
BOEYINK EYECARE PC
Practice address
1109 S Park Street
Carrollton, GA 30117
Phone
(770) 830-0072
Fax
(770) 214-1423
NPI assigned
Feb 16, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Steven John Boeyink, OD
Title
President
Phone
(770) 830-0072

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X OPT001547 GA Primary

Addresses

Primary practice location

1109 S Park Street
Carrollton, GA 30117

Mailing address

1109 S Park Street
Carrollton, GA 30117
Phone (770) 830-0072

National Provider Directory

National Provider Directory

Locations

1109 S Park St
Ste 510
Carrollton, GA 30117
Phone (770) 830-0072

NPI Registry JSON

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

{
    "created_epoch": "1171584000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1821132564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1109 S PARK STREET",
            "city": "CARROLLTON",
            "state": "GA",
            "postal_code": "30117",
            "telephone_number": "770-830-0072",
            "fax_number": "770-214-1423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1109 S PARK STREET",
            "city": "CARROLLTON",
            "state": "GA",
            "postal_code": "30117",
            "telephone_number": "770-830-0072",
            "fax_number": "770-214-1423"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOEYINK EYECARE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-16",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BOEYINK",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_middle_name": "JOHN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "770-830-0072",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "GA",
            "license": "OPT001547",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carrollton, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.