Organization Active NPI

Ferdon Family Eye Care LLC

  • Optometrist
  • Peachtree Corners, GA
National Provider Identifier
1861909160
Registry record updated Jan 8, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
FERDON FAMILY EYE CARE LLC
Practice address
5270 Peachtree Pkwy Ste 109a
Peachtree Corners, GA 30092-6510
Phone
(678) 271-3445
NPI assigned
Jan 8, 2018
Last updated
Jan 8, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2018

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

Authorized official

Name
Chad Ferdon, ODNPI 1588791974
Title
OD/Owner
Phone
(678) 271-3445

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

5270 Peachtree Pkwy Ste 109a
Peachtree Corners, GA 30092-6510

Mailing address

5270 Peachtree Pkwy Ste 109a
Peachtree Corners, GA 30092-6510
Phone (678) 271-3445

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180508002013 GA Part B Supplier - Clinic/Group Practice 8426312950 Receives reassigned benefits from 2 practitioners
Practice locations: Peachtree Corners, GA

National Provider Directory

National Provider Directory

Locations

5270 Peachtree Pkwy
Ste 109A
Peachtree Corners, GA 30092
Phone (678) 271-3445

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1515369600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1515369600000",
    "number": "1861909160",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5270 PEACHTREE PKWY STE 109A",
            "city": "PEACHTREE CORNERS",
            "state": "GA",
            "postal_code": "300926510",
            "telephone_number": "678-271-3445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5270 PEACHTREE PKWY STE 109A",
            "city": "PEACHTREE CORNERS",
            "state": "GA",
            "postal_code": "300926510",
            "telephone_number": "678-271-3445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FERDON FAMILY EYE CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-08",
        "last_updated": "2018-01-08",
        "status": "A",
        "authorized_official_last_name": "FERDON",
        "authorized_official_first_name": "CHAD",
        "authorized_official_title_or_position": "OD/OWNER",
        "authorized_official_telephone_number": "678-271-3445",
        "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 Peachtree Corners, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2018; 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.