Organization Active NPI

Payne & Payne, PC

Doing business as South Forsyth/Alpharetta Eyecare

  • Optometrist
  • Suwanee, GA
National Provider Identifier
1912195272
Registry record updated Apr 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1220 Issued in GA
Legal business name
PAYNE & PAYNE, PC
Doing business as
South Forsyth/Alpharetta Eyecare
Practice address
4330 Johns Creek Pkwy
Suite 300
Suwanee, GA 30024-6047
Phone
(770) 232-7844
Fax
(770) 232-9455
NPI assigned
Oct 11, 2007
Last updated
Apr 27, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2021

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

Authorized official

Name
Dr. Gregory Wade Payne, ODNPI 1306952965
Title
Owner
Phone
(770) 232-7844

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1220 GA Primary

Addresses

Primary practice location

4330 Johns Creek Pkwy
Suite 300
Suwanee, GA 30024-6047

Mailing address

4330 Johns Creek Pkwy
Suite 300
Suwanee, GA 30024-6047
Phone (770) 232-7844

Other practice location 1

9995 Jones Bridge Rd
Alpharetta, GA 30022-6519
Phone (770) 475-1242

Other identifiers 1

IdentifierTypeStateIssuer
DG5938OtherGARAILROAD MEDICARE

Other names 1

  • South Forsyth/Alpharetta Eyecare Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040114000300 GA Part B Supplier - Clinic/Group Practice 5597666545 Receives reassigned benefits from 5 practitioners
Practice locations: Alpharetta, GA; Suwanee, GA

National Provider Directory

National Provider Directory

Locations

9950 Jones Bridge Rd
Ste 200
Johns Creek, GA 30022
Phone (770) 475-1242

9995 Jones Bridge Rd
Johns Creek, GA 30022
Phone (678) 366-1200

9995 Jones Bridge Rd
#200
Johns Creek, GA 30022
Phone (770) 475-1242

4330 Johns Creek Pkwy
Ste 300
Suwanee, GA 30024
Phone (770) 232-7844

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1192060800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1619481600000",
    "number": "1912195272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4330 JOHNS CREEK PKWY",
            "address_2": "SUITE 300",
            "city": "SUWANEE",
            "state": "GA",
            "postal_code": "300246047",
            "telephone_number": "770-232-7844",
            "fax_number": "770-232-9455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4330 JOHNS CREEK PKWY",
            "address_2": "SUITE 300",
            "city": "SUWANEE",
            "state": "GA",
            "postal_code": "300246047",
            "telephone_number": "770-232-7844",
            "fax_number": "770-232-9455"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9995 Jones Bridge Rd",
            "address_purpose": "LOCATION",
            "city": "Alpharetta",
            "state": "GA",
            "postal_code": "300226519",
            "country_code": "US",
            "telephone_number": "770-475-1242",
            "fax_number": "678-366-1344",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PAYNE & PAYNE, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-11",
        "last_updated": "2021-04-27",
        "certification_date": "2021-04-27",
        "status": "A",
        "authorized_official_last_name": "PAYNE",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_middle_name": "WADE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "770-232-7844",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "GA",
            "license": "1220",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DG5938",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "South Forsyth/Alpharetta Eyecare",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "South Forsyth/Alpharetta Eyecare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Suwanee, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.