Coal Mountain Eye Care

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

COAL MOUNTAIN EYE CARE

Practice address

5310 Matt Hwy Ste 301
Cumming, GA 30028-8627

Phone

(662) 910-0735

NPI assigned

Aug 12, 2024

Last updated

Jul 11, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Brett BordnerNPI 1578904314

Title

Owner

Phone

(662) 910-0735

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Locations

Practitioners 1

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.

• Brett S Bordner, OD

  • Optometrist
  • Oakwood, GA
  • NPI 1578904314
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1723420800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1752192000000",
    "number": "1942031976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 HIGHLAND GATE CIR",
            "city": "SUWANEE",
            "state": "GA",
            "postal_code": "300241795",
            "telephone_number": "662-910-0735"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5310 MATT HWY STE 301",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300288627",
            "telephone_number": "662-910-0735"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COAL MOUNTAIN EYE CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-08-12",
        "last_updated": "2025-07-11",
        "certification_date": "2025-07-11",
        "status": "A",
        "authorized_official_last_name": "BORDNER",
        "authorized_official_first_name": "BRETT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "662-910-0735"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2025; 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.