Individual provider Active NPI

Kaitlin Mayo Hawkins, O.D.

  • Optometrist
  • Chatsworth, GA
National Provider Identifier
1881060697
Registry record updated Apr 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT002974 Issued in GA
Practice address
911 N 3Rd Ave
Chatsworth, GA 30705-2115
Phone
(706) 695-4676
Fax
(706) 695-7364
NPI assigned
Aug 16, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPT002974 GA Primary

Addresses

Primary practice location

911 N 3Rd Ave
Chatsworth, GA 30705-2115

Mailing address

1950 Old Gallows Rd Ste 520
Vienna, VA 22182-3970

Other names 1

  • Kaitlin Mayo Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, SC2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20160926001548 GA Practitioner - Optometry 5294022893 Reassigns benefits to 1 organization
I20161031000736 SC Practitioner - Optometry 5294022893 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Myeyedr Optometry of Georgia, LLCGroup PAC ID 8224261201, 100 clinicians

Practice addresses (Care Compare)

911 N 3Rd Ave
Chatsworth, GA 30705-2115
Phone (706) 695-4676

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1891SCMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Myeyedr Optometry of Georgia, LLC Optometrist CurrentSince Sep 3, 2019 Accepting new patients
Myeyedr Optometry of Georgia, LLC Optometrist Current Accepting new patients
S & H Eye Care, LLC Optometrist CurrentSince Nov 1, 2016 Accepting new patients
Myeyedr Optometry of Georgia, LLC Optometrist CurrentSince Sep 3, 2019 Accepting new patients
Myeyedr Optometry of Georgia, LLC Optometrist Past Accepting new patients
Myeyedr Optometry of Georgia, LLC Optometrist Past Accepting new patients

Locations

4875 Altama Ave
Brunswick, GA 31520
Phone (912) 554-0010

123 W Main St
#A
Cartersville, GA 30120
Phone (470) 888-2044

911 N 3rd Ave
Chatsworth, GA 30705
Phone (706) 695-4676

1055 Silver Bluff Rd
Ste A
Aiken, SC 29803
Phone (803) 642-4339

8614 Westwood Center Dr
Fl 9
Vienna, VA 22182

1950 Old Gallows Rd
Ste 520
Vienna, VA 22182

Organizations & group practices 6

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": "1439683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649980800000",
    "number": "1881060697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1950 OLD GALLOWS RD STE 520",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221823970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "911 N 3RD AVE",
            "city": "CHATSWORTH",
            "state": "GA",
            "postal_code": "307052115",
            "telephone_number": "706-695-4676",
            "fax_number": "706-695-7364"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAWKINS",
        "first_name": "KAITLIN",
        "middle_name": "MAYO",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-16",
        "last_updated": "2022-04-15",
        "certification_date": "2022-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "GA",
            "license": "OPT002974",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KAITLIN",
            "last_name": "MAYO",
            "credential": "O.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Chatsworth, GA

Sources for this page

Verify at the official NPI Registry.