Organization Active NPI

Werner Family Eyecare

  • Optometrist
  • Locust Grove, GA
National Provider Identifier
1831887744
Registry record updated Feb 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
WERNER FAMILY EYECARE
Practice address
24 Peeksville Rd
Locust Grove, GA 30248-3125
Phone
(770) 230-0700
Fax
(770) 230-0707
NPI assigned
Apr 27, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2024

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

Authorized official

Name
Dr. Brenda Y. Werner, OD
Title
Ceo/Optometrist
Phone
(770) 230-0700

Specialties & licenses 1

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

Addresses

Primary practice location

24 Peeksville Rd
Locust Grove, GA 30248-3125

Mailing address

24 Peeksville Rd
Locust Grove, GA 30248-3125
Phone (478) 718-3162

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20231215002571 GA Part B Supplier - Clinic/Group Practice 5294184271 Receives reassigned benefits from 1 practitioner
Practice locations: Locust Grove, GA

National Provider Directory

National Provider Directory

Locations

24 Peeksville Rd
Locust Grove, GA 30248
Phone (770) 230-0700

Practitioners & affiliated clinicians

Practitioners 2

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": "1682553600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1707782400000",
    "number": "1831887744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 PEEKSVILLE RD",
            "city": "LOCUST GROVE",
            "state": "GA",
            "postal_code": "302483125",
            "telephone_number": "478-718-3162",
            "fax_number": "770-230-0707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24 PEEKSVILLE RD",
            "city": "LOCUST GROVE",
            "state": "GA",
            "postal_code": "302483125",
            "telephone_number": "770-230-0700",
            "fax_number": "770-230-0707"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WERNER FAMILY EYECARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-04-27",
        "last_updated": "2024-02-13",
        "certification_date": "2024-02-13",
        "status": "A",
        "authorized_official_last_name": "WERNER",
        "authorized_official_first_name": "BRENDA",
        "authorized_official_middle_name": "Y.",
        "authorized_official_title_or_position": "CEO/OPTOMETRIST",
        "authorized_official_telephone_number": "770-230-0700",
        "authorized_official_name_prefix": "Dr.",
        "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 Locust Grove, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2024; 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.