Active NPI
Fareem Jivraj, OD
- Optometrist
- Atlanta, GA
National Provider Identifier
1871145672
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- OPT003170
- Practice address
- 3393 Peachtree Rd NE Ste B128
Atlanta, GA 30326-1197 - Phone
- (857) 269-6286
- NPI assigned
- Jul 11, 2019
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | OPT003170 | GA | Primary |
Addresses
Primary practice location
3393 Peachtree Rd NE Ste B128
Atlanta, GA 30326-1197
Mailing address
3394 Bryerstone Cir SE
Smyrna, GA 30080-4810
Phone (857) 269-6286
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OPT003170 | GA | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1562803200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1562803200000",
"number": "1871145672",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3394 BRYERSTONE CIR SE",
"city": "SMYRNA",
"state": "GA",
"postal_code": "300804810",
"telephone_number": "857-269-6286"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3393 PEACHTREE RD NE STE B128",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303261197",
"telephone_number": "857-269-6286"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JIVRAJ",
"first_name": "FAREEM",
"name_prefix": "Dr.",
"credential": "OD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-07-11",
"last_updated": "2019-07-11",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "GA",
"license": "OPT003170",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Atlanta, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.