Individual provider Active NPI

Grant Paul Macdonald, OD

  • Optometrist
  • Newnan, GA
National Provider Identifier
1841315595
Registry record updated Mar 11, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1560 Issued in GA
Practice address
1065 Sullivan Rd
Suite C
Newnan, GA 30265-5545
Phone
(770) 254-9997
Fax
(770) 254-0134
NPI assigned
Mar 20, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1560 GA Primary

Addresses

Primary practice location

1065 Sullivan Rd
Suite C
Newnan, GA 30265-5545

Mailing address

481 Grant St SE
Atlanta, GA 30312-3154
Phone (404) 932-7163

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
I20071011000329 GA Practitioner - Optometry 1658466867 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1560GAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Sean Carr OD, PC. Optometrist CurrentSince Jul 15, 2007 Accepting new patients
Sean Carr, O.D., P.C. Optometrist CurrentSince Jul 15, 2007 Accepting new patients

Locations

114 Bullsboro Dr
Newnan, GA 30263
Phone (770) 254-9996

20 Baker Rd
Ste 5
Newnan, GA 30265
Phone (770) 254-9997

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1174348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1426032000000",
    "number": "1841315595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "481 GRANT ST SE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303123154",
            "telephone_number": "404-932-7163",
            "fax_number": "770-254-9997"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1065 SULLIVAN RD",
            "address_2": "SUITE C",
            "city": "NEWNAN",
            "state": "GA",
            "postal_code": "302655545",
            "telephone_number": "770-254-9997",
            "fax_number": "770-254-0134"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACDONALD",
        "first_name": "GRANT",
        "middle_name": "PAUL",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-20",
        "last_updated": "2015-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "GA",
            "license": "1560",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newnan, GA

Sources for this page

Verify at the official NPI Registry.