Athens Vision Centers, LLC
Organization Active NPI Optometrist · Elberton, GA
NPI 1972205136 · NPPES record last updated Mar 21, 2023
Key facts
- NPI
- 1972205136
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Optometrist 152W00000X
- Legal business name
- ATHENS VISION CENTERS, LLC
- Practice address
- 17 S Thomas St
Elberton, GA 30635-2453 - Phone
- (706) 549-9993
- Fax
- (706) 549-4047
- NPI assigned
- Mar 21, 2023
- Organization subpart
- Yes
- Parent organization (as reported)
- KELLER, CRYMES, & DEMARCO LLC
Authorized official
- Name
- Mr. John Henry Bo Dalton
- Title
- Administrator
- Phone
- (706) 433-2031
Parent organization (reported in NPPES) 1
Corporate family (same tax ID) 1
Member of 1
Practitioners 5
-
Don R Dye, O.D.
-
Paul Logan Seay, O.D.
-
Walter A Sams IV, MD
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in GA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20230718001717 | GA | Part B Supplier - Clinic/Group Practice | 7911367255 |
Receives reassigned benefits from 4 practitioners Practice locations: Elberton, GA; Toccoa, GA; Lavonia, GA |
National Provider Directory
- Tax ID family
- Athens Eye Doctors and Surgeons LLC
- Part of
- Keller Crymes Demarco LL
Locations
105 Trinity Pl
Athens, GA 30607
Phone (706) 433-2035
17 S Thomas St
Elberton, GA 30635
Phone (706) 283-2351
13375 Jones St
Ste B2
Lavonia, GA 30553
Phone (706) 356-0206
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist |
152W00000X | Yes | ||
| Ophthalmology Physician |
207W00000X |
Addresses
Primary practice location
17 S Thomas St
Elberton, GA 30635-2453
Mailing address
105 Trinity PL
Athens, GA 30607-2112
Phone (706) 549-9993
Other names
- Athens Eye Doctors and Surgeons, LLC
Other providers in Elberton, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 21, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.