Individual provider Active NPI

Nicole Akpunku, OD

  • Optometrist
  • Alpharetta, GA
National Provider Identifier
1881180628
Registry record updated Sep 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT003103 Issued in GA
Practice address
3975 Old Milton Pkwy Ste 2
Alpharetta, GA 30005-4467
Phone
(678) 624-7766
Fax
(678) 624-7766
NPI assigned
Jul 5, 2018
Last updated
Sep 14, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPT003103 GA Primary

Addresses

Primary practice location

3975 Old Milton Pkwy Ste 2
Alpharetta, GA 30005-4467

Mailing address

1950 Old Gallows Rd Ste 520
Vienna, VA 22182-3970
Phone (703) 847-8899

Other practice location 1

5370 Campbellton Fairburn Rd Ste 410
Fairburn, GA 30213-2296
Phone (770) 629-4351

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
I20180830003605 GA Practitioner - Optometry 7113277799 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Myeyedr. Optometry of Georgia, LLC Optometrist CurrentSince Oct 19, 2020 Accepting new patients
Myeyedr Optometry of Georgia, LLC Optometrist CurrentSince Oct 19, 2020 Accepting new patients
Myeyedr Optometry of Georgia, LLC Optometrist Current Accepting new patients
Kelechi Eye Associates LLC CurrentSince Feb 1, 2023 Accepting new patients
Jackson Family Eye Care, LLC Optometrist Past Accepting new patients

Locations

3975 Old Milton Pkwy
Ste 2
Alpharetta, GA 30005
Phone (678) 624-7766

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

1436 Dogwood Dr SE
Conyers, GA 30013
Phone (770) 860-8544

1438 Dogwood Dr SE
Conyers, GA 30013
Phone (678) 607-1318

1950 Old Gallows Rd
Ste 520
Vienna, VA 22182

8614 Westwood Center Dr
Fl 9
Vienna, VA 22182

Organizations & group practices 5

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

NPI Registry JSON

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

{
    "created_epoch": "1530748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694649600000",
    "number": "1881180628",
    "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",
            "telephone_number": "703-847-8899",
            "fax_number": "571-223-6780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3975 OLD MILTON PKWY STE 2",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300054467",
            "telephone_number": "678-624-7766",
            "fax_number": "678-624-7766"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5370 Campbellton Fairburn Rd Ste 410",
            "address_purpose": "LOCATION",
            "city": "Fairburn",
            "state": "GA",
            "postal_code": "302132296",
            "country_code": "US",
            "telephone_number": "770-629-4351",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AKPUNKU",
        "first_name": "NICOLE",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-05",
        "last_updated": "2023-09-14",
        "certification_date": "2023-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "GA",
            "license": "OPT003103",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Alpharetta, GA

Sources for this page

Verify at the official NPI Registry.