Organization Active NPI

Eyenova Eyecare, LLC

  • Optometrist
  • Flowery Branch, GA
National Provider Identifier
1821941444
Registry record updated Feb 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
EYENOVA EYECARE, LLC
Practice address
7380 Spout Springs Rd Ste 420
Flowery Branch, GA 30542-7542
Phone
(678) 899-0011
NPI assigned
Feb 16, 2026
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2026

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

Authorized official

Name
Maria Kim, ODNPI 1184768715
Title
Optometrist/Owner
Phone
(678) 267-5843

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

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

Addresses

Primary practice location

7380 Spout Springs Rd Ste 420
Flowery Branch, GA 30542-7542

Mailing address

7380 Spout Springs Rd Ste 420
Flowery Branch, GA 30542-7542
Phone (678) 899-0011

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20260420001068 GA Part B Supplier - Clinic/Group Practice 5799251591 Receives reassigned benefits from 1 practitioner
Practice locations: Flowery Branch, GA

National Provider Directory

National Provider Directory

Locations

7380 Spout Springs Rd
Ste 420
Flowery Branch, GA 30542
Phone (678) 899-0011

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1771200000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1771200000000",
    "number": "1821941444",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7380 SPOUT SPRINGS RD STE 420",
            "city": "FLOWERY BRANCH",
            "state": "GA",
            "postal_code": "305427542",
            "telephone_number": "678-899-0011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7380 SPOUT SPRINGS RD STE 420",
            "city": "FLOWERY BRANCH",
            "state": "GA",
            "postal_code": "305427542",
            "telephone_number": "678-899-0011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYENOVA EYECARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-02-16",
        "last_updated": "2026-02-16",
        "certification_date": "2026-02-16",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "MARIA",
        "authorized_official_title_or_position": "OPTOMETRIST/OWNER",
        "authorized_official_telephone_number": "678-267-5843",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flowery Branch, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.