Active NPI
Robert Winburn Penland, O.D.
- Optometrist
- Athens, GA
National Provider Identifier
1962482729
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 1930
- Practice address
- 3654 Atlanta Hwy
Athens, GA 30606-6979 - Phone
- (706) 208-9491
- Fax
- (706) 543-8912
- NPI assigned
- Jan 18, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 1930 | GA | Primary |
Addresses
Primary practice location
3654 Atlanta Hwy
Athens, GA 30606-6979
Mailing address
3654 Atlanta Hwy
Athens, GA 30606-6979
Phone (706) 208-9491
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Optometry
- Education
- Other, 2001
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
105 Trinity PL
Athens, GA 30607-2112
Phone (706) 549-9993
Merit-based Incentive Payment System (MIPS)
- Final score
- 93.59 of 100
- Quality
- 100
- Improvement activities
- 40
- Cost
- 78.65
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1930 | GA | MD | Optometrist |
| 001930 | GA | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Keller Crymes & Demarco LLC | Current | Accepting new patients | |
| Keller, Crymes, & Demarco LLC | Current | Accepting new patients |
Locations
105 Trinity Pl
Athens, GA 30607
Phone (706) 433-2035
1115 S Elm St
Commerce, GA 30529
Phone (706) 335-5139
23 East Sq
Washington, GA 30673
Phone (706) 678-3926
Organizations & group practices 2
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.
-
- Ophthalmology Physician
- Athens, GA
- NPI 1467406983
-
- Eyewear Supplier
- Athens, GA
- NPI 1790907277
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1137542400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1962482729",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3654 ATLANTA HWY",
"city": "ATHENS",
"state": "GA",
"postal_code": "306066979",
"telephone_number": "706-208-9491",
"fax_number": "706-543-8912"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3654 ATLANTA HWY",
"city": "ATHENS",
"state": "GA",
"postal_code": "306066979",
"telephone_number": "706-208-9491",
"fax_number": "706-543-8912"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PENLAND",
"first_name": "ROBERT",
"middle_name": "WINBURN",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-01-18",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "GA",
"license": "1930",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Athens, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.