James Jeffrey Clark, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

1184 Issued in GA

Practice address

210 S 16TH St
Griffin, GA 30224-2663

Phone

(770) 229-8700

Fax

(770) 229-5008

NPI assigned

Dec 19, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Southern College of Optometry, 1989

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Procedures performed for Medicare patients

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.

• Eye Doctors Center, P.C.

  • Optometrist
  • Griffin, GA
  • NPI 1568528537
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1166486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1366156800000",
    "number": "1891859682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 S 16TH ST",
            "city": "GRIFFIN",
            "state": "GA",
            "postal_code": "302242663",
            "telephone_number": "770-229-8700",
            "fax_number": "770-229-5008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 S 16TH ST",
            "city": "GRIFFIN",
            "state": "GA",
            "postal_code": "302242663",
            "telephone_number": "770-229-8700",
            "fax_number": "770-229-5008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "JAMES",
        "middle_name": "JEFFREY",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-19",
        "last_updated": "2013-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "GA",
            "license": "1184",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000419218B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Christian Ministries Hospice, Inc
• Christian Ministries Volunteer Organization
• Hugh Allen Christie, PH.D.
• John T Chryssochoos, M.D.
• Onyebuchi Hannah Chukwuebuni, MD
• Patricia Susan Clark, DPT
• Clearview Counseling & Wellness Services, Inc
• Atlantia Neshay Clements, M. ED., SLP
• David E Clements Sr., RPH
• Shermaine Demetric Cleveland

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2013; 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.