Active NPI
Boeyink Eyecare PC
- Optometrist
- Carrollton, GA
National Provider Identifier
1821132564
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- OPT001547
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 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 DirectoryLocations
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.