Javeya Clark, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPT003200 Issued in GA

Practice address

3645 Habersham Rd NE
Atlanta, GA 30305-1130

Phone

(404) 549-9999

NPI assigned

Sep 16, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Optometry

Education

University Alabama Birmingham - School of Optometry, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Perimeter Vision Care LLCGroup PAC ID 0547685810, 18 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Perimeter Vision Care, LLC

  dba Atlanta Eye Group Tucker

  • Optometrist
  • Atlanta, GA
  • NPI 1215611546
  Medicare reassignment Care Compare group NPD
• Perimeter Vision Care, LLC

  dba Atlanta Eye Group

  • Optometrist
  • Atlanta, GA
  • NPI 1811527971
  NPD
• Family Eye Care Center of Atlanta, Inc

  • Optometrist
  • Morrow, GA
  • NPI 1154569069
  NPD (past)

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

{
    "created_epoch": "1568592000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568592000000",
    "number": "1891345575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1568 REEL LAKE DR SW",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303318961",
            "telephone_number": "251-714-6261"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3645 HABERSHAM RD NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303051130",
            "telephone_number": "404-549-9999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "JAVEYA",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-16",
        "last_updated": "2019-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "GA",
            "license": "OPT003200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Doren Louise Clark, NURSE PRACTITIONER
• Jabari Clark
• James Andrew Clark, M.D.
• Janelle Clark
• Jason A Clark, M.D.
• Jeffrey Ira Clark, MD
• Jessica Taylor Clark, PT, DPT
• Johanna J Clark, CSA
• Julia Clark, LMSW
• Kathleen Linton Clark, APRN-BC

• Optometrist in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Optometrist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.